Up to 25% of patients with acute heart failure (AHF) face mortality or hospital readmission within one month after being treated in the emergency department (ED).
GUIDED-HF, a self-care intervention studied by Vanderbilt University Medical Center researchers, decreases the risk of cardiovascular-related deaths and hospital readmissions for AHF patients and improves quality of life after an ED visit and discharge.
This intervention will now be studied as usual care as part of an implementation project at Oregon Health and Science University in Portland and Henry Ford Health System in Detroit.
Eligible patients who are discharged from the ED will be educated about important aspects of disease management and provided educational information on how to best manage their symptoms once they are discharged, allowing a safe transition from hospital to home.
“This tool kit helps someone to navigate the system, someone who may not already have a system in place to successfully do so,” said co-principal investigator Sean Collins, MD, MSci, professor of Emergency Medicine at VUMC. “For example, it helps someone who may not have a doctor to follow up with, or someone who may have challenges with health literacy and not understand how they take their medications, when they should weigh themselves or how much salt to have in their diet.”
The program’s initial research was reported in JAMA Cardiology, and funded by Patient-Centered Outcomes Research Institute (PCORI). Now, PCORI is providing $1.25 million in funding so that additional health care facilities can implement the GUIDED-HF.
“My goal is for health care providers to use this without even thinking about it,” said co-principal investigator Deonni Stolldorf, PhD, RN, assistant professor at Vanderbilt University School of Nursing. “We will involve as many providers as possible — doctors, advanced nurse practitioners, physician assistants and administrators.”
Stolldorf and Collins will work with Oregon Health Services and Henry Ford Health System in Detroit to incorporate GUIDED-HF protocols into their electronic health records.
“We will meet with the local teams to understand their challenges,” said Stolldorf. “We will tailor the implementation strategies to make this program successful for their ED, including taking surveys, assembling focus groups, using champions and providing educational support.”
The newly funded project will undergo research for up to six months before the EDs start using the GUIDED-HF program.
“We hope this becomes a routine part of the practice when you are discharging someone at these two sites and eventually at other ERs in the U.S.,” said Collins. “We hope it is something easy to deploy that helps both patients and providers so we can make a difference in a patient’s outcome and cut costs in overall health care.”
The American Heart Association’s (AHA) Get with the Guidelines-Heart Failure program is included in the GUIDED-HF.
