1. ACAC Symposium April 14th, 2008: Chinook Health 11 Improving Access to Heart Failure Services in Chinook Health Building the Heart Failure Network ACAC Symposium April 14th, 2008: Chinook Health sspenceley@chr.ab.ca jpenner@chr.ab.ca

2. 1 ACAC Symposium April 14th, 2008: Chinook Health 2 Today….  The issue  Where we are  Where we want to go  How ACAC is helping us get there

3. 1 ACAC Symposium April 14th, 2008: Chinook Health 3 The Issue

4. 1 ACAC Symposium April 14th, 2008: Chinook Health 4 Chinook Heart Function Clinic  Physician directed, nurse-managed clinic established in 2001, offering:  Expert assessment and follow up  A customized, evidence-based treatment plan  Education and self-management strategies and support  Support and connections to community resources

5. 1 ACAC Symposium April 14th, 2008: Chinook Health 5 Good News…and Bad News We are providing quality care and achieving good outcomes in the HFC but…. Seen in Heart Function Specialty Clinic Heart Failure Population in Chinook

6. 1 ACAC Symposium April 14th, 2008: Chinook Health 6 We know that many patients struggle with HF management…  Many patients visit the ER, are treated for HF and discharged  Many patients are admitted to acute care facilities for exacerbations of heart failure  Many patients struggle in the community with frequent episodes of instability

7. 1 ACAC Symposium April 14th, 2008: Chinook Health 7 Increasing our Reach We seek to create a network of health care providers across the continuum of care who are informed and committed to providing comprehensive, evidence-based heart failure care. The Heart Failure Network

8. 1 ACAC Symposium April 14th, 2008: Chinook Health 8 HFN: Two Phases Phase 1: Urban  Lethbridge and immediate area  There are a number of gaps  Centralizes our initial efforts in one venue Phase 2: Rural  Interdisciplinary primary care teams generally more established  Communication strengths between health care providers/agencies in smaller locales

9. 1 ACAC Symposium April 14th, 2008: Chinook Health 9 The Heart Failure Network (HFN)…  offers navigational support and centralized access to information and resources for patients, families and health care providers living with and caring for chronic heart failure.  focuses on improving the lifestyle of heart failure patients  creates connections between clients and available community resources.  builds on existing strengths to improve heart failure care in Chinook.

10. 1 ACAC Symposium April 14th, 2008: Chinook Health 10 The Patient Journey: HFN 3 Visits:  Initial  Within 7-14 days of discharge (or referral from community)  Visit # 2  Within 30 days of discharge/referral  Heart Failure Education Class  Visit # 3  Within 30-60 days of discharge/referral

11. 1 ACAC Symposium April 14th, 2008: Chinook Health 11 Currently…  Comprehensive Communication Plan  Internal/external audiences  Identifying and addressing policy gaps  Referral processes  Physician orders/evidence-informed care

12. 1 ACAC Symposium April 14th, 2008: Chinook Health 12 Currently…  First patients seen April 1!