What is the project focus?
Pediatric heart dysfunction or failure is a significant, burdensome and complex condition associated with high morbidity and mortality. The estimated incidence of heart failure is 0.9-7.4 per 100,000 children. Each year in the United States, tens of thousands of children are admitted for heart failure with an in-hospital mortality rate of 7%. Children with congenital heart disease admitted with severe heart failure requiring intravenous inotropes, in-hospital mortality climbs to 26%. Despite the significant healthcare utilization of pediatric heart failure patients, treatment and management strategies are often ‘borrowed’ from adult medicine. In addition, there is also extreme variation in care practices depending on which institution is caring for the child.
During a heart failure admission, whether for a new diagnosis or in a chronic patient, patients are at risk for complications including death. We are focused on the following initiatives to improve outcomes:
- Improving communication about treatment goals among care team members (including patients)
- Formalizing discharge plans for patients/families and the outpatient care team to aide in a seamless care transition.
- Establishing a medication regimen and titrating to goal doses to help the heart have the best chance at recovery.
Who is impacted?
All pediatric patients hospitalized with acute decompensated heart failure are able to be included for both the communication and discharge project. Patients seen in the hospital or the outpatient clinic with heart failure are included in the medication titration project.
What are we doing to help?
We have made a Communication Checklist, Discharge Plans (patient material example below), and Medication Titration Tool.
What data do we have?
We tracked the use of the daily communication checklist, total completion of HF patients being enrolled in the HF registry, and length of stay for HF patients