Developing a "Hub and Satellite" Heart Failure Provider's Network: A New Model of Community Based Outpatient Clinic (CBOC) Providers Study
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 20 - 70 |
| Updated: | 10/14/2017 |
| Start Date: | May 2010 |
| End Date: | May 2011 |
Developing a Hub and Satellite Heart Failure Providers Network
The aim of this study is to serve as a pilot showing the feasibility of a "Hub and Satellite"
Heart Failure (HF) Provider's Network which will aim to provide improved, evidence-based care
to veterans with HF. Primary Care Providers in the VA Community Based Outpatient Clinics will
undergo a brief period of intensive training in HF management and then practice in a network
of primary care providers supported by the Regional HF Center.
Heart Failure (HF) Provider's Network which will aim to provide improved, evidence-based care
to veterans with HF. Primary Care Providers in the VA Community Based Outpatient Clinics will
undergo a brief period of intensive training in HF management and then practice in a network
of primary care providers supported by the Regional HF Center.
Background:
Congestive heart failure (HF) is a major public health problem. There is a pressing need to
improve treatment of HF, but lifesaving therapies remain underused in clinical practice. We
proposed a novel, potentially cost-effective model of community-based, multidisciplinary,
collaborative HF care - the "Hub and Satellite" Heart Failure Providers Network. Primary care
providers trained in HF management would provide improved care to their clinic patients with
HF in "satellite" clinics, supported by the Regional HF Center "hub".
Objectives:
1. To establish and demonstrate the feasibility of the "Hub and Satellite" Heart Failure
Providers Network
2. To obtain data examining clinical effectiveness and barriers
Methods:
Volunteer community-based primary care providers underwent 3 days of HF management training
at the regional HF center (Nashville), consisting of 21 hours of lectures, briefings,
teaching sessions and case presentations. Multiple choice testing and a survey interview were
completed at the beginning and end of training. Exclusive access was given to the services of
a clinical pharmacist to titrate HF medications to clinical guideline-recommended doses.
Providers received updates on advances in HF management. A confidential feedback report on
their performance was given to HF providers. Formative evaluation was performed through
pre-educational and 4 subsequent telephone interviews with HF providers.
DSS data was used to identify patients with systolic HF (ejection fraction<40%) cared for by
the HF providers; systolic HF patients in the same clinics cared for by non-HF trained
providers were randomly selected as controls. Data on the care received over the one year
period of follow-up was collected from DSS data and the computerized patient record system
(CPRS).
Status:
One year of study follow-up has been completed. Primary data analysis is continuing. Work
done to date has successfully demonstrated the feasibility of implementing a "Hub and
Satellite" HF Providers network, including high provider satisfaction.
Congestive heart failure (HF) is a major public health problem. There is a pressing need to
improve treatment of HF, but lifesaving therapies remain underused in clinical practice. We
proposed a novel, potentially cost-effective model of community-based, multidisciplinary,
collaborative HF care - the "Hub and Satellite" Heart Failure Providers Network. Primary care
providers trained in HF management would provide improved care to their clinic patients with
HF in "satellite" clinics, supported by the Regional HF Center "hub".
Objectives:
1. To establish and demonstrate the feasibility of the "Hub and Satellite" Heart Failure
Providers Network
2. To obtain data examining clinical effectiveness and barriers
Methods:
Volunteer community-based primary care providers underwent 3 days of HF management training
at the regional HF center (Nashville), consisting of 21 hours of lectures, briefings,
teaching sessions and case presentations. Multiple choice testing and a survey interview were
completed at the beginning and end of training. Exclusive access was given to the services of
a clinical pharmacist to titrate HF medications to clinical guideline-recommended doses.
Providers received updates on advances in HF management. A confidential feedback report on
their performance was given to HF providers. Formative evaluation was performed through
pre-educational and 4 subsequent telephone interviews with HF providers.
DSS data was used to identify patients with systolic HF (ejection fraction<40%) cared for by
the HF providers; systolic HF patients in the same clinics cared for by non-HF trained
providers were randomly selected as controls. Data on the care received over the one year
period of follow-up was collected from DSS data and the computerized patient record system
(CPRS).
Status:
One year of study follow-up has been completed. Primary data analysis is continuing. Work
done to date has successfully demonstrated the feasibility of implementing a "Hub and
Satellite" HF Providers network, including high provider satisfaction.
Inclusion Criteria:
Healthcare providers (physicians, nurse practitioners, physician's assistants) who practice
in a Community Based Outpatient Clinic (CBOC) in the Tennessee Valley Healthcare System,
and are willing to undergo Heart Failure Training
Exclusion Criteria:
Community Based Outpatient Clinic (CBOC) Providers who are unable to attend the 3 day Heart
Failure Training at the Regional Heart Failure Center.
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