Hospitalization following an emergency-department visit for worsening heart failure: The role of left ventricular ejection fraction

Mollar, Anna; Lorenzo, Miguel; Villaescusa, Amparo; Heredia, Raquel; Miñana, Gema; Santas, Enrique; Espriella, Rafael de la; Sastre, Clara; Civera, Jose; Martínez, Ana García; Conesa, Adriana; Sanchís, Juan; Núñez, Eduardo; Bayés‐Genís, Antoni; Núñez, Julio

doi:10.1016/j.medcli.2021.09.026

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…Currently, specific clinics and models of care for HFpEF are rare across health systems, [6,7,35] and the condition is poorly recognized and understood. [36,37] This must be addressed given recent therapeutic advances to ensure effective and equitable care provision. [2,38] While this study focused on heart failure care in England, a wide variety of approaches to improve heart failure care have been evaluated internationally.…”

Section: "So Even a Nurse Practitioner At The Practice Whose Keeping ...mentioning

confidence: 99%

Informing understanding of coordination of care for patients with heart failure with preserved ejection fraction: a secondary qualitative analysis

Brooman-White,

Blakeman,

McNab

et al. 2023

BMJ Qual Saf

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BackgroundPatients with heart failure with preserved ejection fraction (HFpEF) are a complex and underserved group. They are commonly older patients with multiple comorbidities, who rely on multiple healthcare services. Regional variation in services and resourcing has been highlighted as a problem in heart failure care, with few teams bridging the interface between the community and secondary care. These reports conflict with policy goals to improve coordination of care and dissolve boundaries between specialist services and the community.AimTo explore how care is coordinated for patients with HFpEF, with a focus on the interface between primary care and specialist services in England.MethodsWe applied systems thinking methodology to examine the relationship between work-as-imagined and work-as-done for coordination of care for patients with HFpEF. We analysed clinical guidelines in conjunction with a secondary applied thematic analysis of semistructured interviews with healthcare professionals caring for patients with HFpEF including general practitioners, specialist nurses and cardiologists and patients with HFpEF themselves (n=41). Systems Thinking for Everyday Work principles provided a sensitising theoretical framework to facilitate a deeper understanding of how these data illustrate a complex health system and where opportunities for improvement interventions may lie.ResultsThree themes (working with complexity, information transfer and working relationships) were identified to explain variability betweenwork-as-imaginedandwork-as-done. Participants raised educational needs, challenging work conditions, issues with information transfer systems and organisational structures poorly aligned with patient needs.ConclusionsThere are multiple challenges that affect coordination of care for patients with HFpEF. Findings from this study illuminate the complexity in coordination of care practices and have implications for future interventional work.

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Section: "So Even a Nurse Practitioner At The Practice Whose Keeping ...mentioning

confidence: 99%

Informing understanding of coordination of care for patients with heart failure with preserved ejection fraction: a secondary qualitative analysis

Brooman-White,

Blakeman,

McNab

et al. 2023

BMJ Qual Saf

View full text Add to dashboard Cite

show abstract

Hospitalization following an emergency-department visit for worsening heart failure: The role of left ventricular ejection fraction

Cited by 1 publication

References 27 publications

Informing understanding of coordination of care for patients with heart failure with preserved ejection fraction: a secondary qualitative analysis

Informing understanding of coordination of care for patients with heart failure with preserved ejection fraction: a secondary qualitative analysis

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