Heart Failure :: Teamwork improves care for chronic heart failure

Active patient involvement during treatment of chronic heart failure, coupled with partnership with healthcare team members to provide care consistent with evidence-based guidelines, dramatically improves quality of care for chronic heart failure patients.

The study by researchers from the Indiana University School of Medicine, the Regenstrief Institute, Inc. and the Richard Roudebush VA Medical Center in Indianapolis, published in the January 2007 issue of the journal Medical Care, reported on chronic heart failure patients in 143 Department of Veterans Affairs Medical Centers nationwide.

Chronic heart failure is a serious condition caused by structural or functional cardiac problems impairing the ability of the heart to pump blood. Risk factors for chronic heart failure include previous heart attack, high blood pressure or diabetes.

“We found hospitals providing complex care like the care needed for chronic heart failure perform significantly better when members of the patient’s health-care team collectively work together to follow processes and procedures incorporated in national guidelines. Facilities with providers receptive to the guidelines, which have guideline-specific task forces to support implementation and a well-planned implementation process were those who gave the highest quality of care for patients with chronic heart failure,” said the study’s senior author, Bradley Doebbeling, M.D., M.S., professor of health services research and medicine at the IU School of Medicine and program director for health services research at the Regenstrief Institute.

“The patient is a crucial team member as well. Without patient involvement, significant goals like dietary change or adherence to medicine regimens cannot be met,” he said.

Lifestyle changes, such as exercising, reducing salt intake, managing stress, and especially losing weight are closely associated with longer chronic heart failure patient survival.

“Interdisciplinary teamwork, physician and other provider engagement, and coordination of care, combined with the involvement of patients and the VA’s integrated health care delivery system, promotes very high levels of quality and safety. Other hospital systems can learn from these effective provider – patient partnerships,” said Dr. Doebbeling, who directs the Center of Excellence in Implementing Evidence Based Practice at the Roudebush VA Hospital and the IU Center for Health Services & Outcomes Research.

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