Managing patients with heart failure in primary care

The Victorian Department of Health partnered with five primary health networks to build the capacity of general practices to manage patients with heart failure across Victoria. Eastern Melbourne Primary Health Network led the project.

The project provided funding of $7,000 (ex. GST) per practice, education and support to empower practices to apply a whole-of-practice approach to quality improvement (QI). Practices utilised the Heart Plan in a Box QI toolkit, which offers six plan-do-study-act cycles on heart failure topics.

22 clinics completed the project including four in the NWMPHN region, which were:

• Cohealth Collingwood
• Lincolnville Medical Centre
• Moreland West Medical Centre
• Wyndham Health Care

Practice teams completed clinical education and peer learning activities in three online workshops. Practices also had access to education sessions with a heart failure clinical nurse consultant. QI facilitators from each PHN assisted and mentored clinics throughout the project.

The project aimed to improve the capacity of general practice to better assess people at risk of heart disease and manage patients with heart failure across Victoria. This aim was successfully achieved.

Outcomes included:

• Correct identification of five-year mortality in patient with heart failure with reduced ejection fraction (HFrEF) increased from 20 per cent to 44 per cent.
• Identification of the four pillars of medical therapy increased from 44 per cent to 56 per cent.
• Identification of patient need for a heart failure action plan rose from 70 per cent to 82 per cent.
• Staff who regularly or occasionally accessed heart failure resources increased from 24 per cent to 89 per cent.
• Confidence in accessing patients’ echocardiography results rose from 38 per cent to 56 per cent.
• Awareness of and access to heart failure nurse practitioners or advanced practice nurses rose from 18 per cent to 65 per cent.

Although the overall impact of the project was positive, there were also several limitations affecting the quality and validity of data collected and analysed. It is recommended that the data set be simplified for future related projects.