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The Heart Failure Clinical Programme and it’s impact on Cardiac Rehabilitation

The Heart Failure Clinical Programme and it’s impact on Cardiac Rehabilitation. Karen Cradock, B. Physio , MSc. Therapy Lead. The scale of Heart Failure in Ireland ~ 300,000 people with ‘LV Dysfunction’; more than 100,000 with HF. 2. IHF 2001. The Heart Failure Pyramid.

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The Heart Failure Clinical Programme and it’s impact on Cardiac Rehabilitation

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  1. The Heart Failure Clinical Programme and it’s impact on Cardiac Rehabilitation Karen Cradock, B. Physio, MSc. Therapy Lead

  2. The scale of Heart Failure in Ireland~ 300,000 people with ‘LV Dysfunction’; more than 100,000 with HF 2 IHF 2001

  3. The Heart Failure Pyramid HF patients with a history of admission Symptomatic HF in the community Asymptomatic Ventricular dysfunction 15,000 – Sick HF 85,000 – Stable HF 250,000 – Impending HF

  4. Heart Failure: Problems and Solutions Life Cycle Ideal : 85 yrs 40 yrs Life Cycle with Heart Failure: First Diagnosis At Risk Hospitalisations 75 yrs 40 yrs Prevention Community Mx Hospital

  5. Heart Failure Solution Life Cycle of Heart Failure in 2011: Hospitalisations 40 yrs 75 yrs Life Cycle with Heart Failure Programme: 76 yrs 40 yrs

  6. OVERARCHING AIM TO IMPROVE QUALITY OF LIFE FOR PATIENTS WITH HEART FAILURE IN IRELAND

  7. Objectives Access • Every patient with symptoms of heart failure is diagnosed correctly and without delay Quality • Every patient with heart failure is managed within a structured programme • Implement targeted programme to prevent heart failure Cost • Reduce recurrent admissions by 1,000 with additional impact on de novo admissions • Reduce length of stay saving 20,000 hospital days per year

  8. IMPLEMENTATION OF PROGRAMME • Heart Failure Clinical Lead • 2 WTE Heart Failure Nurses in hospitals accepting acute admissions (1.5 WTE HFN in hospitals with mainly non acute admissions and providing out patient services) • Administrative support available • Adequate clinical space to see patients available • Structures in place for timely access to BNP and echocardiography • Access to therapy services

  9. Note: Access to Monday to Friday 5 day per week clinic for unscheduled visit

  10. Active National Programmes • St. Vincent’s University Hospital • Tallaght Hospital • St. James Hospital • Mater Hospital • Beaumont Hospital • Our Lady of Lourdes Hospital, Drogheda • Wexford General Hospital • Galway University Hospital • Portiuncula Hospital, Ballinasloe

  11. Key performance indicators

  12. Cochrane Review- Exercise based Rehabilitation for Heart Failure

  13. Training

  14. Units planning for implementation of the National Heart Failure Programme (Sept 2012) • Connolly Hospital • Cavan/Monaghan Hospital Group • Mid Western Regional Hospital, Limerick • Sligo General Hospital

  15. Impact of Programme on Cardiac Rehabilitation • All current programme sites have cardiac rehabilitation programmes- likely to be referred- will they be included in the group sessions? • Can cardiac rehabilitation become integral part of this care structure?

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