The Status of Specialized Ambulatory Heart Failure Care in Canada: A Joint Canadian Heart Failure Society and Canadian Cardiovascular Society Heart Failure Guidelines Survey
Sean A Virani
(1)
,
Shelley Zieroth
(2)
,
Sharon Bray
(3)
,
Anique Ducharme
(4)
,
Karen Harkness
(5)
,
Sheri L Koshman
(6)
,
Michael Mcdonald
(7)
,
Eileen O’meara
(4)
,
Elizabeth Swiggum
(1)
,
Michael Chan
(8)
,
Justin A Ezekowitz
(6)
,
Nadia Giannetti
(9)
,
Adam Grzeslo
(10)
,
George A Heckman
(11)
,
Jonathan G Howlett
(12)
,
Serge Lepage
(13)
,
Lisa Mielniczuk
(14)
,
Gordon W Moe
(15)
,
Mustafa Toma
(1)
,
Howard Abrams
(16)
,
Abdul Al-Hesaye
(15)
,
Alain Cohen-Solal
(17, 18)
,
Michel d'Astous
(19)
,
Sabe De
(20)
,
Diego Delgado
(21)
,
Olivier Desplantie
(1)
,
Estrellita Estrella-Holder
(22)
,
Lee Green
(6)
,
Haissam Haddad
(23)
,
Adrian F Hernandez
(24)
,
Simon Kouz
(25)
,
Marie-Hélène Leblanc
(26)
,
Douglas Lee
(21)
,
Frederick A Masoudi
(27)
,
Sylvain Matteau
(28)
,
Robert Mckelvie
(20)
,
Marie-Claude Parent
(4, 29)
,
Miroslaw Rajda
(30)
,
Heather J Ross
(21)
,
Bruce Sussex
(31)
1
UBC -
University of British Columbia
2 University of Manitoba [Winnipeg]
3 LEP - Lived Experience Partner [Toronto, ON, Canada]
4 Montreal Heart Institute - Institut de Cardiologie de Montréal
5 Hamilton Health Sciences
6 University of Alberta
7 University Health Network
8 Royal Alexandra Children's Hospital
9 MUHC - McGill University Health Center [Montreal]
10 McMaster University [Hamilton, Ontario]
11 University of Waterloo [Waterloo]
12 University of Calgary
13 UdeS - Université de Sherbrooke
14 University of Ottawa [Ottawa]
15 St. Michael's Hospital
16 IRCCS Milan - Istituto Clinico Humanitas [Milan]
17 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
18 Hôpital Lariboisière-Fernand-Widal [APHP]
19 CHUDGLD - Dr. Georges-L.-Dumont University Hospital Centre
20 Western University [London, ON, Canada]
21 University of Toronto
22 SBGH - Saint Boniface General Hospital [Winnipeg, MA, Canada]
23 U of S - University of Saskatchewan [Saskatoon]
24 Duke University [Durham]
25 CHRDL - Centre Hospitalier Régional de Lanaudiere [Joliette, QC, Canada]
26 IUCPQ - Institut Universitaire de Cardiologie et de Pneumologie de Québec
27 University of Colorado Anschutz [Aurora]
28 HRC - Hôpital régional Chaleur [Bathurst, NB, Canada]
29 UdeM - Université de Montréal
30 HSC - QEII Health Sciences Centre [Halifax, NS, Canada]
31 MUN - Memorial University of Newfoundland = Université Memorial de Terre-Neuve [St. John's, Canada]
2 University of Manitoba [Winnipeg]
3 LEP - Lived Experience Partner [Toronto, ON, Canada]
4 Montreal Heart Institute - Institut de Cardiologie de Montréal
5 Hamilton Health Sciences
6 University of Alberta
7 University Health Network
8 Royal Alexandra Children's Hospital
9 MUHC - McGill University Health Center [Montreal]
10 McMaster University [Hamilton, Ontario]
11 University of Waterloo [Waterloo]
12 University of Calgary
13 UdeS - Université de Sherbrooke
14 University of Ottawa [Ottawa]
15 St. Michael's Hospital
16 IRCCS Milan - Istituto Clinico Humanitas [Milan]
17 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
18 Hôpital Lariboisière-Fernand-Widal [APHP]
19 CHUDGLD - Dr. Georges-L.-Dumont University Hospital Centre
20 Western University [London, ON, Canada]
21 University of Toronto
22 SBGH - Saint Boniface General Hospital [Winnipeg, MA, Canada]
23 U of S - University of Saskatchewan [Saskatoon]
24 Duke University [Durham]
25 CHRDL - Centre Hospitalier Régional de Lanaudiere [Joliette, QC, Canada]
26 IUCPQ - Institut Universitaire de Cardiologie et de Pneumologie de Québec
27 University of Colorado Anschutz [Aurora]
28 HRC - Hôpital régional Chaleur [Bathurst, NB, Canada]
29 UdeM - Université de Montréal
30 HSC - QEII Health Sciences Centre [Halifax, NS, Canada]
31 MUN - Memorial University of Newfoundland = Université Memorial de Terre-Neuve [St. John's, Canada]
Shelley Zieroth
- Function : Author
- PersonId : 1214338
- ORCID : 0000-0002-6145-9814
Anique Ducharme
- Function : Author
- PersonId : 1214339
- ORCID : 0000-0003-1681-9187
Abstract
This joint Canadian Heart Failure Society and the CCS Heart Failure guidelines report has been developed to provide a pan-Canadian snapshot of the current state of clinic-based ambulatory heart failure (HF) care in Canada with specific reference to elements and processes of care associated with quality and high performing health systems. It includes the viewpoints of persons with lived experience, patient care providers, and administrators. It is imperative to build on the themes identified in this survey, through engaging all health care professionals, to develop integrated and shared care models that will allow better patient outcomes. Several patient and organizational barriers to care were identified in this survey, which must inform the development of regional care models and pragmatic solutions to improve transitions for this patient population. Unfortunately, we were unsuccessful in incorporating the perspectives of primary care providers and internal medicine specialists who provide the majority of HF care in Canada, which in turn limits our ability to comment on strategies for capacity building outside the HF clinic setting. These considerations must be taken into account when interpreting our findings. Engaging all HF care providers, to build on the themes identified in this survey, will be an important next step in developing integrated and shared care models known to improve patient outcomes.
Origin : Publication funded by an institution