부산대학교 도서관

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 ʼredesignʼ 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.