Heart Failure Care-Less than Ideal circumstances !

Challenge

The challenge in this situation was the medical Care of Heart Failure patients. We work with this largely  elderly, vulnerable and mostly economically challenged type of patients among other cardiac patients.  This type of illness has a high mortality rate and severely compromises the patient’s quality of life.  Nevertheless, so much could be done given the appropriate follow up and medications.

Due to the capacity of the staff, given that we have other patients to attend to, and the limited resources  we lost a considerable portion of those patients mainly because of loss to follow up.

Selection

We have applied a learning launch of a dedicated Heart Failure Team where there is a specific referral  room purely assigned to heart failure patients. The concept was to overcome the limitations that we have  by dedicating two days/week where we only focus our efforts to this particular type of patients. The team  should consist of all the required professionals starting with trained nurse, a clinical pharmacist, cardiac  rehabilitation specialist, a psychologist and doctor.

The reason we selected to launch this trial; is the fact that we knew from our patients they wanted more  than merely a quick review of medication and clinical status. They have felt the previous method looked at  them as files and prescriptions more than patients that deserve better life quality. We knew we had to  develop a more tailored system that fits their needs.

Application

Following that we have organized ourselves and approached the management with the project.  Unfortunately, there was no convenient room available. Therefore, we have agreed to use a room utilized  by colleagues from another department after their scheduled hours and only once a week, the week  following this approval we started telling a portion of our patients about the dedicated clinic and the  available hours and three weeks later we started.

Insight

The basics to this is that instead of the patient meeting only one type of health care practitioner this  patient would be able to meet all the relevant ones as to guide and help. In the first month, more than  85% of the patients came back for the scheduled follow up visits as compared to about 35-40 % using the  conventional way. The patients’ feedback was they had a considerable improvement in their lives and  they were now able to do activities they never thought they were ever able to do again. Even though it  was a success from the patients perspective, it was a struggle for us as staff. The fact that we had to  move other activities and patients from this day made the rest of the weekdays even more loaded, they  were also days that the room was not available on time because our colleagues patients either ran late or  had un-foreseen issues that required more time to deal with.

Alternative Approach

We are currently in trial to develop a more convenient approach to this problem without jeopardizing the  patient satisfaction we had so far. Given the limited resources we have and the number of staff members,  it is highly questioned that we would be able to create a dedicated team and premises to this. Therefore,  it is up for us to create a convenient schedule that would best fit all, the team and the patients.

