Heart success program: An interdisciplinary patient-centered approach to cancer patients with concurrent heart failure

Fadol, Anecita; Adornetto-Garcia, D.; Shelton, Valerie; Durand, Jean Bernard; Yeh, Edward T.H.; Summers, Barbara L.

doi:10.1016/j.ppedcard.2015.10.007

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…To provide comprehensive holistic care to patients with cancer and HF, we implemented a patient-centered, interprofessional initiative, the Heart Success Program (HSP), in 2012. The HSP [9] reduced the 30-day hospital readmission rate from 40 to 27%. To further reduce the hospital readmission rate, the HSP committee then initiated a quality improvement process utilizing the DMAIC (Define, Measure, Analyze, Improve and Control) method [10] in 2017.…”

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confidence: 95%

A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure

et al. 2019

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Background: The management of patients with cancer and concurrent heart failure (HF) is challenging. The increased complexity of treatment and the occurrence of multiple overlapping symptoms may lead to frequent hospital admissions, which may result in cancer treatment delays, a diminished quality of life, and an increased financial burden for the patient's family. To provide holistic care to oncology patients with HF, we implemented the Heart Success Program (HSP), a patient-centered, interprofessional collaborative practice, which decreased the 30day hospital readmission rate for HF diagnosis from 40 to 27%. However, this rate remains higher than that reported for Medicare beneficiaries. Aim: To identify the factors contributing to frequent readmissions, the HSP committee participated in the institution's Clinical Safety and Effectiveness and utilize quality improvement methodologies and tools to decrease hospital readmission for HF. Methods: The DMAIC (Define, Measure, Analyze, Improve and Control) method was used to guide this quality improvement. Areas considered as having high impact and requiring low effort to address were patient education barriers, lack of documentation clarity, and care provider knowledge gaps about the HSP. We implemented workflow changes, improved clarity with documentation of HF diagnosis, and increase provider knowledge about the HSP. Findings: After 6 months of implementing quality improvement techniques, the 30-day hospital readmission rate for HF patients fell by 23.43% (from 31.7% for the baseline period to 8.27%), exceeding the target project goal of 10%. Our quality improvement method may also be effective in improving the management of patients with cancer and other comorbid conditions.

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confidence: 95%

A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure

et al. 2019

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“…Additionally, cancer patients have a high prevalence of baseline cardiovascular risk factors and cardiovascular disease (CVD) prior to initiation of cancer therapy, making them more vulnerable to cardiovascular injuries, which may increase their risk of developing cardiomyopathy leading to HF and death. Management of patients with multiple comorbidities requires multiple providers and specialists which can predispose to the risk of fragmented and inefficient care ( 5 ). Over the course of cancer therapy, cancer patients with multiple comorbidities are managed by multidisciplinary teams with a concentrated effort on treating cancer, and the focus on the cardiotoxic effects of cancer treatments may be minimalized which can result in adverse cardiac outcomes and unplanned hospitalizations.…”

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confidence: 99%

Management of Chemotherapy-Induced Left Ventricular Dysfunction and Heart Failure in Patients With Cancer While Undergoing Cancer Treatment: The MD Anderson Practice

Fadol

2018

Front. Cardiovasc. Med.

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Chemotherapy-induced cardiotoxicity resulting in heart failure (HF) is one of the most dreaded complications of cancer therapy that can significantly impact morbidity and mortality. With a high prevalence of cardiovascular disease in cancer patients, the risk of developing HF is significantly increased. A new discipline of Onco-Cardiology has evolved to address the cardiovascular needs of patients with cancer, however, there is limited evidence-based data to guide clinical decision-making in the management of the cardiovascular complications of cancer therapy. The department of cardiology at MD Anderson Cancer Center initiated the MD Anderson Practice (MAP) project and developed algorithms to guide the management of the cardiovascular complications of cancer therapy. For chemotherapy-induced HF, we initiated the Heart Success Program (HSP), a patient-centered program that promotes interdisciplinary collaboration for the management of concurrent HF resulting from chemotherapy-induced cardiotoxicity. After one year of HSP implementation, compliance with the Center for Medicare and Medicaid Services HF core measures has significantly improved. The measurement of LVEF and initiation of recommended pharmacologic therapy for HF (angiotensin converting enzyme inhibitor [ACE-I] or angiotensin receptor blocker for ACE-I intolerant patients) has improved to 100%; provision of discharge instruction has improved from 50 to 94%; and the 30-day hospital readmission rate decreased from 40 to 27%. This article will describe the MD Anderson Practice in the management of chemotherapy-induced cardiomyopathy and HF in cancer patients through the HSP. The novelty of the HSP has raised clinician’s awareness of the magnitude of the clinical problem of HF in cancer and the

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Heart success program: An interdisciplinary patient-centered approach to cancer patients with concurrent heart failure

Cited by 2 publications

References 16 publications

A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure

A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure

Management of Chemotherapy-Induced Left Ventricular Dysfunction and Heart Failure in Patients With Cancer While Undergoing Cancer Treatment: The MD Anderson Practice

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