Heart failure (HF) is associated with a high mortality and morbidity, reduced quality of life and increasing health care costs in Australia as well as across the world. The projected crude prevalence of HF is expected to increase significantly as the population ages. People >65 years of age have a higher prevalence of all cardiovascular disease, and this population will grow significantly in the next two decades.
The rising trend in mortality and hospital admissions is likely to continue as the aging population grows. HF prognosis remains poor, often due to late diagnosis and inadequate management and support. 20-30% of people with mild to moderate heart failure will die within one year and 50% of people with severe heart failure will die within one year.
There is an expected 25% growth in prevalence of HF by 2030 compared to 2010; and to a doubling of the direct medical costs associated with HF. Within this context, HF constitutes a public health problem that has been characterised as an emerging epidemic by the World Health Organisation.
To understand the journey a person who has heart failure a study on the current state at Monash Health has been undertaken. Click on this link for full report
In addition over three years Monash Health Hospital Admission Risk Program has led a large scale systems reform for Heart Failure care. The system redesign has had a focus on responsiveness and demonstrating excellence in care delivery. Most significantly is the Complex Care response which links inpatient and ED patients with specialty community based Nurse Practitioner and Clinical Nurse Consultant care and support. This service has a focus on (where appropriate) early discharge and community follow up this includes Lasix titration in community and linkages with G.P. for continuity of care. The following system monitoring and controls have been put in place
– Clinical risk screening discharged patients within 2/7days
– Clinical indicators to measure service delivery of best practice
– Peer audits of translating evidence to practice
– Protocol for deteriorating clients in community
– Feedback from patients in Appendix A clearly demonstrates people value this service delivery model