“Comparison of Outcomes and Access to Care for Heart Failure Trial”
Heart failure is a condition where the heart pump does not function normally causing the lungs to become congested. The primary symptom of heart failure is shortness of breath, and this often leads to patients visiting the emergency department for care. Decision-making in the emergency department is a high-stakes situation, where there is a need for decision support to guide clinicians to make better decisions about admission to hospital or discharge home. Many low-risk patients who could potentially be managed at home are admitted to hospital whereas some patients who are thought safe to discharge are actually high risk and will have adverse outcomes if they are discharged home from the emergency department. In this trial, the investigators will study a new strategy for heart failure care, comprised of a computer algorithm to help doctors make decisions in the emergency department about the risk of their patient. For low-risk patients who are discharged home from the emergency department or after a short hospital stay, patients will be referred to a rapid follow-up clinic where the heart specialist team will rapidly assess and treat patients.
Risk stratification and transitional care intervention
Intervention consists of 2 components: Risk stratification: Determination of risk using the EHMRG 7-day and 30-day risk scores, where decision to admit, observe, or discharge the patient will be guided by the result of the risk scores Transitional care: Follow-up care in the RAPID-HF transitional care clinic begins at 48 hours after emergency department or hospital discharge. Care provided by cardiologist + nurse for up to 30 days after emergency department or hospital discharge.
Comparison of Outcomes and Access to Care for Heart Failure Trial