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THE PROVINCIAL HEART FAILURE STRATEGY AT WORK: CREATING STANDARDIZED HEART FAILURE END OF LIFE SYMPTOM MANAGEMENT PRACTICE RESOURCES FOR BRITISH COLUMBIA’S (BC) HEART FAILURE HEALTH CARE PROVIDERS
CCCN Abstracts
initiative. It fosters collaboration through teamwork and communication based on the principles of effective teams. The goal is to provide an open forum to problem solve and make decisions around complex cases related to patient care and management, current practices and processes. Meetings occur weekly and are attended by registered nurses, triage coordinators, research coordinators, nurse practitioners, physicians and manager. This presentation will discuss the evolution of case rounds, role of the team members, process and outcomes in the provision of safe and effective quality care. The value of this initiative includes the use of evidenced-based practice, quality assurance and improvement, team cohesiveness and consensus building through collaboration and consultation. Health care providers encounter numerous challenging cases in their daily practice. Decisions on patient care management often require in-depth analysis and thorough deliberation. Case rounds provide an effective solution to this challenge which influences safe, patient-centred and quality care. NP013 THE PROVINCIAL HEART FAILURE STRATEGY AT WORK: CREATING STANDARDIZED HEART FAILURE END OF LIFE SYMPTOM MANAGEMENT PRACTICE RESOURCES FOR BRITISH COLUMBIA’S (BC) HEART FAILURE HEALTH CARE PROVIDERS B Catlin1, C Galte2, B Hennessy3, M Daniel4, E Garland5, P Luehr6, I See7 1
Cardiac Services BC, Vancouver, BC, 2 Fraser Health, New Westminister, BC, Northern Health, Prince George, BC, 4 Vancouver Island Health, Nanaimo, BC, 5 Providence Health,Vancouver, BC, 6 Interior Health, Kelowna, BC, 7 Vancouver Coastal Health, Vancouver, BC 3
In May, 2012, the BC Provincial Heart Failure (HF) Strategy mandate was expanded to include standardizing HF End of Life (EOL) care across British Columbia (BC). The expansion was based on outcomes from a provincial forum, where health care providers (HCP) and patients identified the need to standardize HF EOL care within three specific domains: 1- HF symptom management, 2- managing HF technology, and 3identifying specialists’ roles and responsibilities. As well, the standardization needed to focus on each level of transition HF patients experience at EOL This presentation will outline the provincial work specifically within the HF EOL symptom management domain. To address the new mandate a provincial HF EOL working group was established which recognized the existence of EOL symptom management resources for malignancy; however these resources did not reflect the specific needs of HF EOL patients. As well the current EOL resources were not HF specific enough to guide HCP practice. The working group agreed to adopt and adapt the general palliative symptom management guidelines but also created six additional HCP practice resources that reflected symptoms more salient to HF EOL patients.
S369
This presentation will focus on the development of the HF EOL practice resources. The presenters will describe the process, the interprofessional lens and the evidence based foundations by which the resources were developed. As well the practice resources will be show cased and described in detail. Lastly discussion regarding implications for patient care and nursing practice will be highlighted. NP014 DESCRIPTION OF FREQUENT USERS IN THE EMERGENCY DEPARTMENT TO IMPROVE CARE C Bolduc1, S Cossette2, V Beaulieu2, M-H Carbonneau2 1 Université de Montréal, Montréal, QC, 2 Institut de Cardiologie de Montréal, Montréal, QC
BACKGROUND:
Frequent emergency department (ED) users negatively impact ED efficiency. The goal of this clinical project is to identify possible predictive factors and the pattern of health care use in order to envisage interventions to improve the care for these patients. METHOD: Patients who visited the ED at the Montreal Heart Institute, a tertiary hospital specialized in cardiology, seven times or more during a one year period from 2012 to 2013 were selected. Possible predictive factors were selected using the Behavioral Model of Health Service Use of Andersen (2008) and the Chronic Care Model of Wagner (1998). The electronic databases Oacis, Medurge and Magic were used to collect data. Additional clinical encounters with five frequent users in 2014 permitted to better understand the profiles and needs of this clientele. RESULTS: We found 31 frequent ED users during this period, amassing a total of 272 ED visits. The results show that the majority are aged 65 and over and that patients who more frequently visit outpatient clinics visit the ED less often. The main diagnoses of frequent ED users were: decompensated heart failure, auricular arrhythmias and atypical thoracic pains. Besides these predictive factors, we also observed that the frequent ED users of the one year period studied are no longer frequent ED users the following year as only two (13 %) of them have visited the ED seven times or more the year after. CONCLUSION: Examining the pattern of health care use allows us to define predictive factors of frequent ED use and helps to identify ways in which to improve care for frequent ED users, whilst optimizing the coordination of resources of the health service. NP015 INTRA-PROVINCIAL COLLABORATION FOR VAD PATIENT CARE TRANSITIONS C duManoir1, A Kaan2, W Chiu2, J Kealy2 1
Interior Health, Kelowna, BC, 2 Providence Health, Vancouver, BC
Supporting patients with a Ventricular Assist Device (VAD) during transitions in care is difficult. When the patient and family are from a distant community, the challenge is even greater. In the past, patients supported by a VAD were
initiative. It fosters collaboration through teamwork and communication based on the principles of effective teams. The goal is to provide an open forum to problem solve and make decisions around complex cases related to patient care and management, current practices and processes. Meetings occur weekly and are attended by registered nurses, triage coordinators, research coordinators, nurse practitioners, physicians and manager. This presentation will discuss the evolution of case rounds, role of the team members, process and outcomes in the provision of safe and effective quality care. The value of this initiative includes the use of evidenced-based practice, quality assurance and improvement, team cohesiveness and consensus building through collaboration and consultation. Health care providers encounter numerous challenging cases in their daily practice. Decisions on patient care management often require in-depth analysis and thorough deliberation. Case rounds provide an effective solution to this challenge which influences safe, patient-centred and quality care. NP013 THE PROVINCIAL HEART FAILURE STRATEGY AT WORK: CREATING STANDARDIZED HEART FAILURE END OF LIFE SYMPTOM MANAGEMENT PRACTICE RESOURCES FOR BRITISH COLUMBIA’S (BC) HEART FAILURE HEALTH CARE PROVIDERS B Catlin1, C Galte2, B Hennessy3, M Daniel4, E Garland5, P Luehr6, I See7 1
Cardiac Services BC, Vancouver, BC, 2 Fraser Health, New Westminister, BC, Northern Health, Prince George, BC, 4 Vancouver Island Health, Nanaimo, BC, 5 Providence Health,Vancouver, BC, 6 Interior Health, Kelowna, BC, 7 Vancouver Coastal Health, Vancouver, BC 3
In May, 2012, the BC Provincial Heart Failure (HF) Strategy mandate was expanded to include standardizing HF End of Life (EOL) care across British Columbia (BC). The expansion was based on outcomes from a provincial forum, where health care providers (HCP) and patients identified the need to standardize HF EOL care within three specific domains: 1- HF symptom management, 2- managing HF technology, and 3identifying specialists’ roles and responsibilities. As well, the standardization needed to focus on each level of transition HF patients experience at EOL This presentation will outline the provincial work specifically within the HF EOL symptom management domain. To address the new mandate a provincial HF EOL working group was established which recognized the existence of EOL symptom management resources for malignancy; however these resources did not reflect the specific needs of HF EOL patients. As well the current EOL resources were not HF specific enough to guide HCP practice. The working group agreed to adopt and adapt the general palliative symptom management guidelines but also created six additional HCP practice resources that reflected symptoms more salient to HF EOL patients.
S369
This presentation will focus on the development of the HF EOL practice resources. The presenters will describe the process, the interprofessional lens and the evidence based foundations by which the resources were developed. As well the practice resources will be show cased and described in detail. Lastly discussion regarding implications for patient care and nursing practice will be highlighted. NP014 DESCRIPTION OF FREQUENT USERS IN THE EMERGENCY DEPARTMENT TO IMPROVE CARE C Bolduc1, S Cossette2, V Beaulieu2, M-H Carbonneau2 1 Université de Montréal, Montréal, QC, 2 Institut de Cardiologie de Montréal, Montréal, QC
BACKGROUND:
Frequent emergency department (ED) users negatively impact ED efficiency. The goal of this clinical project is to identify possible predictive factors and the pattern of health care use in order to envisage interventions to improve the care for these patients. METHOD: Patients who visited the ED at the Montreal Heart Institute, a tertiary hospital specialized in cardiology, seven times or more during a one year period from 2012 to 2013 were selected. Possible predictive factors were selected using the Behavioral Model of Health Service Use of Andersen (2008) and the Chronic Care Model of Wagner (1998). The electronic databases Oacis, Medurge and Magic were used to collect data. Additional clinical encounters with five frequent users in 2014 permitted to better understand the profiles and needs of this clientele. RESULTS: We found 31 frequent ED users during this period, amassing a total of 272 ED visits. The results show that the majority are aged 65 and over and that patients who more frequently visit outpatient clinics visit the ED less often. The main diagnoses of frequent ED users were: decompensated heart failure, auricular arrhythmias and atypical thoracic pains. Besides these predictive factors, we also observed that the frequent ED users of the one year period studied are no longer frequent ED users the following year as only two (13 %) of them have visited the ED seven times or more the year after. CONCLUSION: Examining the pattern of health care use allows us to define predictive factors of frequent ED use and helps to identify ways in which to improve care for frequent ED users, whilst optimizing the coordination of resources of the health service. NP015 INTRA-PROVINCIAL COLLABORATION FOR VAD PATIENT CARE TRANSITIONS C duManoir1, A Kaan2, W Chiu2, J Kealy2 1
Interior Health, Kelowna, BC, 2 Providence Health, Vancouver, BC
Supporting patients with a Ventricular Assist Device (VAD) during transitions in care is difficult. When the patient and family are from a distant community, the challenge is even greater. In the past, patients supported by a VAD were