Core Heart Team
Heart Failure affects many long-term care residents, but it can be better managed with new care processes. This project supports all members of the long-term care team in the detection, diagnosis, and management of this chronic condition.
The purpose of this project is to improve heart failure (HF) management in long-term care. Poor management of HF may lead to unplanned hospital transfers which can be avoided. The project is unique because it involves training team members in the nursing department (for example, registered practical nurses, personal support workers), team members in other departments (for example, housekeepers), as well as physicians. This new approach for managing HF was trialed in one neighbourhood of a long-term care home during a pilot study and is now being scaled up to reach additional neighbourhoods. Once the approach is shown to work well, the hope is to spread Core Heart Team to additional homes.
There are four phases involved in Core Heart Team:
1. Tailored education for team members, family members and residents
2. Workshops to supplement the initial education and to optimize communication practices between team members
3. Physician education and engagement
4. Integration of principles in bedside teaching with physicians and members of the core heart team