DOI: 10.1161/circ.148.suppl_1.12961 ISSN: 0009-7322

Abstract 12961: Heart Failure Redesign Across a Newly Integrated Health System

Kismet Rasmusson, Jenna Miller, Jeffrey Goss, Rami Alharethi, Ruchika Husa, Corey Lum, Vicki Koceja, Kaley Graham, Jennifer Springer, Theresa Ketterling, Merrilee Phillips, Reuben Evans, Carrie Willis, Susan Longman, Simon Payne
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Heart Failure (HF) challenges are magnified when healthcare mergers and expansions occur requiring significant integration of operational and clinical effort. With enterprise support, we brought HF teams together from a newly merged system to 'redesign' HF care aiming to provide high level, consistent, evidence-based, patient-centered care in a novel, adaptive model where such roadmaps do not exist.

Hypothesis: Integrated care across a large network can be patient centered, of high value, with a proper framework.

Methods: Representatives from 3 distinct, newly aligned regions of Intermountain Health completed a care redesign program aimed to integrate HF services. Current processes, tools, education were evaluated then mapped to identify barriers and most impactful areas to guide redesign.

Results: Over 6 months, 45 multidisciplinary HF specialists met weekly. Current state was mapped for 9 markets across 3 regions reaching >38,089 patients. Baseline data revealed areas for improvement: readmissions, mortality, advanced care planning, transitions in care. 141 barriers were identified, 39 of high impact, 15 are the primary focus; includes increasing access to stage-based care, implementing a guideline-directed referral pathway and providing market-specific resources. 4 teams built an operating system to support a new HF standard (image). Elements culminated in a consistent care path across the HF Stages for the newly formed enterprise. Implementation is underway; outcomes will be forthcoming.

Conclusion: Building HF care across a large healthcare organization takes both clinical and operational leadership through shared learning. With a vision and framework this redesigned system aims to increase ease and access while providing high quality, patient-centered, consistent care regardless of location. Attention to high areas of opportunity requires operational prioritization, subject matter expertise, and resource support.

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