Heart Failure Action Plan

Milestones

/ Barriers/
Challenges / Strategy / Most Responsible Person Other resources / Time frame
Establishing baseline / 1. Time and tools to complete the review /
  • Adopt the audit tool from HI for data collection and analysis.

Implementation of Heart Failure Pathway and GAP tool / 1. Physician resistance to standing orders /
  • Physician champion role
  • Providing data feedback

2. Staffing issues
. Shortage/turnover
. Change resistance
. Not available for education sessions /
  • In-service presentations
  • Short presentations using templates provided
  • Emphasize baseline results
  • Tools support complete and consistent care
  • Use poster in-services in high profile places

3. Confusion about clinical data /
  • Provide information about inclusion and exclusion and how stats are provided

4. Documentation
. Perceived additional workload /
  • Replace existing forms where possible –avoid duplication

5. Lack of staff buy-in /
  • Promote project buy-in
  • Administration to publicly support
  • Sufficient posters for awareness

6. Emergency dept not incorporated into projects /
  • ER buy-in
  • Recruit an ER physician champion or develop strategy for their involvement

7. New forms not being used
. Incorrect use
. Failure to use /
  • Promote form use
  • Obtain feedback during planning and design phase
  • Unit champion to monitor status and address unit specific issues
  • Evaluate availability of forms
  • Provide in-service for clerks based on their role for chart management.
  • Focus on ease of documentation.
  • Reenergize with variety of strategies ie: posters with results, in-services; reward program; one to one feedback

8. Phased Pathway a new way of providing care to CHF patients /
  • Develop a strategy where all Heart Failure patients are placed on the map.
  • Determine need for physician and clinical staff education.

Implementation of CIHI coding for monitoring of results / 1. Time constraints for monitoring tool use /
  • Monitoring strategies
  • Implementation of data capture through CIHI
  • Mechanism to ensure that every patient has a tool i.e.: manager reviews chart at discharge; staff review chart at discharge; health records alerts unit if patient diagnosis is Heart Failureand does not have tool.
  • Need to develop a process that is timely.

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