Heart Failure Patients and Early Consultation to Palliative Care

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Walker, Brandi
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Purpose: Increase the number of consults to the palliative care team in heart failure (HF) patients with an ejection fraction (EF) of 40% or less.|Background: HF is a chronic progressive condition that causes physical and psychological suffering. Due to the condition’s complexity, treatment presents challenges for both patients and providers. Integrating palliative care early in the diagnosis can improve patient outcomes and symptom management.|Sample/Setting: The setting included inpatient floors at a VA hospital. The sample consisted of veterans who received an echocardiogram while hospitalized from January 1, 2019, to December 6, 2021. Data from 2020 were excluded due to altered hospital processes.|Methods: A quality improvement (QI) project took place as data were gathered from 2019 and 2021. Data from 2020 were not analyzed as hospital processes were altered due to Covid-19. An analysis of echocardiogram results was performed using a 2019 data group compared to data in 2021. The QI project involved educating pertinent staff to improve the frequency of palliative consults placed in patients with an EF of less than 40%.|Results: In 2019, 75% of palliative consults were correctly placed based on specific EF criteria of 40% or less. In 2021, 73% of palliative consults were correctly placed. However, when looking specifically at if a palliative consult was placed or not, in 2019 only 13% of patients with an EF of 40% or less received a consult and in 2021, 30% of patients received a consult.|Conclusion: After providing education to staff, results noted little statistical difference in the number of correctly placed palliative consults placed based on specific delineated EF criteria. However, when looking at the data that identified if a palliative consult was placed, a significant improvement in the number of patients who received consults occurred.
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