Care of the person with heart failure
Introduction
A condition in the heart does not satisfy the needs of the body while pumping blood is heart failure. Doctors say that in some cases the heart does not fill with sufficient blood. To some patients with heart failure, heart is not able to pump blood to the rest of the body with enough force to run through the veins and arteries. Some people have both problems and when it comes to that point, they call for serious medication and attention. It is therefore necessary to mention that the term heart failure does not mean that the heart cannot work or pump blood. (Wegner,69)
The care model developed more than a decade ago is an approach adopted with the purposes of improving ambulatory care that has been the guide to clinical quality initiatives in the world and especially in the United States of America. There has been accumulated evidence for supporting the chronic care model as an incorporated structure to guide practice revamp. Regardless of work remaining in areas like cost effectiveness, studies suggest that redesigning care with the help of chronic care model has in the past improved patient care and there have been better health outcomes. The evidence on chronic care model is so far very encouraging but there is need of better tools for helping practices advance their systems. (Wegner,88)
Models of care and treatment settings integration and co-ordination to ensure the continuity of quality care for the patient
Integration of care models and treatment settings has always been difficult because not all settings can accommodate the models of care. Coordination also has been an issue for many years but recently specialists formulated ways of integration and coordination. The heart failure care model’s work and other models used while taking care of a person with heart failure is to improve the coordination and integration as well as interrelationship between elements that are evident based and which lead to improved clinical quality. For instance, in order for patients to engage in a proactive care or delivery system design, practices should be able to view all of the heart failure patients in the panels or clinical information systems who are in need of certain treatments based on guidelines. Patients must agree to all changes made in their care and integrate them into their lives commonly referred to as self-management support. As such, heart failure care models interventions, integration and coordination focus on practice redesign across most of the elements and settings. Nevertheless, evaluation of RAND shows that practice teams integrate, and coordinate as well as implement some of the models with more than others. Specialists say that it is easier to integrate some models to treatment settings and information systems receive the most attention while community linkages receive the least attention. (Wegner, 19)
There have been several observational studies showing the relationship between presence of heart failure care models and quality of care after integration with treatment settings. Generally, all studies show how simple it is to integrate models of care and treatment settings if the relationship between the patient and the caregiver is okay. Implementation, coordination and integration of Composite measures of chronic care models associate with either improvements of care quality as per the outcome measures. Almost all the researchers acknowledge challenges associated with disentangling multicomponent interventions.
Heart failure is a major death and disability cause worldwide. This translates to 59% of deaths and 46% of the burden of the same disease globally. Despite the advances in treatment effectiveness, patients do not get the care they require or need. This is where the chronic care model comes in because it helps practices improve health outcomes of the patient through changing the routine giving of ambulatory care using six interrelated system changes meant to make evidence based and patient centered care easier to achieve. The main aim of the care model is transforming the daily patients care with heart failure from reactive and acute to planned, proactive and populace based. It has a design to accomplish these goals because the model has the ability to combine planned interactions and effective team care; self-management support bolstered by effective use of resources in the community; integrated decision support; patient registries and other inclusive and supportive information technology. (Chin, 456)
The basis of designing these elements is giving care to patients with heart failure and to work together in order to strengthen the relationship between the one giving care and the patient and improve the overall health outcomes.
The initial evidence basing heart failure care model was from a review of care improvement interventions for various chronically ill populations. The evaluations displayed that multicomponent practice changes in different categories translated to the greatest improvements in the outcomes of health. This led to increments in providers, expertise and skill. This was also useful while educating and supporting patients therefore making care delivery more team based and planned as well as making better use of information systems based on registry. These changes formed the basis of heart failure care model.
Literature review recommendations for the future and care of heart failure patients
Intervention practices patients receive improved care resulting to better treatment and progress compared to patients in control practices. Such patients are more knowledgeable about the disease and use recommended therapies. Such therapies recommended for future self and general care of heart failure patients include lowering lipids and amniotes sin converting enzyme inhibition therapy as often as one can. In future, asthmatic patients should take care not to develop cardiovascular diseases by getting medical attention and getting proper recommendations on what food to eat. It is clear to all that care begins with oneself and creating a good relationship with the caregiver improves the results as well. (Homer, 345) Although diabetic patients have lower risks of developing cardiovascular diseases, it is good to monitor the heart functionalities and use recommended practices. From all over the world, the best way to care for such patients is integrating care models and treatment settings together because they improve the quality of care given. (Wegner,29)
In heart failure care models based efforts of improvements, should be purely upon the degree of health outcome improvement among the participating parties, which in this case are the caregivers and patients. Although there could be a correlation between the variations and nature or extent of heart failure care model, caregivers should be aware that contextual factors within each practice setting could also have influence on the ability of teams making changes and improving care. There should be use of many types of practices using the heart failure care model in order to redesign care given to the heart failure patients. To give the best care, organizations should try use or have clinical information technology and other related resources such as computers, well trained heart failure caregivers and improve the standards of the facility. Such facilities should have fitness equipments to ensure care is a maximum level. There are no defined standards of care giving; however, each facility should get the best ratings from patients to show that they are giving best care. Caregivers should personalize their relationships with the patients to communicate well. With communication breakdown, care giving is very difficult and to some extents impossible.
There is need for further research to understand care giving for patients with heart failure diseases and interrelationships between baseline characteristics of practice organizations, changes they make using the care model implementation, patient outcomes and changes in care for the same patients. All these are recommendations to ensure that there is good care given to people with heart failure diseases especially now that the number is going up at an alarming rate. Both children and adults are getting the disease and should get the best care as a right to live. (Wegner,79)
What governments and health services can do to improve the delivery of service to these patients?
Most affordable health care organizations giving health services to heart failure patients are governmental and rely on the government for funds and medications. Such organizations need to expend considerable resources through the government and set aside certain amounts of money to improve their services. The government should also expend effort to transform health care practices in accord with the care model and other related models that can best give care to heart failure patients. Evidence suggests that transformation leads to improved patient care and outcomes but health care costs and revenues remain uncertain and vary from time to time by condition. The government should chip in and prevent such variations so that patients can get care but affordably and timely. Many tend to run to governmental health care services but on getting there, they realize that there are poor care giving conditions and increased revenues. (homer, 199)
Governments should come up with a way of providing free care to heart failure patients or lower the revenues. The heart failure care model fro example recommends services and delivery modes with poor reimbursement or no reimbursement at all in most schemes that require fee in order to give service. Many qualified caregivers move to private organizations because they get better working conditions and better pay. This is where the government should come in and offer the best packages to retain the good employees because in a country, the government should retain the best workforce and give the best services and salaries. (Wegner,99)
There should be schemes introduced by the government to cater for low earners and ensure that everybody gets proper care with best models integrated. Having in mind that many health plans, Medicaid agencies and employers, including the government as an employer, have turned to direct management of the disease for the patient in efforts to give improved care for the chronically ill and reduce costs. This is a positive thing and in future, heart failure management will become very easy and affordable. Recently, reviews and evidence have questions on the effectiveness of disease management programs that do not connect to patients closely in terms of primary care clinicians (Homer, 66)
Conclusion
Heart failure disease is a fast killing illness and it calls for government intervention. Government comes in handy in matters related to facilities and cost of care services. Many deaths are because of neglect and poverty. The disease affects people across all ages, social status class and gender. There is no given theory to show that the disease between children and adults mostly affects but looking at the number of deaths across the world, children are the most affected by the disease. Chronic care model is the best model to integrate to health practices and treatment settings. Clinically the model is abbreviated as CCM and it is very common care model in hospitals. The study is not limited to this care model and there are other models for care giving.
References
E.H. Wagner, B.T. Austin, & Von Korff, M. 1996, ‘Organizing Care for Patients with heart failure Illness’, Milbank Quarterly, no. 4, pp. 511–544
E.H. Wagner, von M. 1998, ‘heart failure Disease Management: What Will It Take to Improve Care for Chronic Illness?’ Effective Clinical Practice, no. 1, pp. 2–4.
Renders, C.M. 2002, Interventions to Improve the Management of heart failure in Primary Care, Outpatient, and Community Settings, Cochrane, Database of Systematic
Reviews, NSW.
Casalino, L.P. 2005, Disease Management and the Organization of Physician Practice, American Medical Association, Taylor, America. T. Bodenheimer, E.H. Wagner, & Grumbach, K. 2002, Improving Primary Care for Patients with Chronic Illness, American Medical Association, Taylor, America.
T.Bodenheimer, E.H. Wagner, & Grumbach, K. 2002, Improving Primary Care for Patients with Chronic Illness, The heart failure Care Model, Spencer, America.
Wagner, E.H. 2001, Improving heart failure Care, Translating Evidence into Action, John and Spencer, new York times, New York.
Cretin, S.M. Shortell, & Keeler, E.B. 2004, An Evaluation of Collaborative Interventions to Improve heart failure Illness Care, Framework and Study Design, Hegel, university press, UK.
Pearson, M.L. 2005, assessing the Implementation of the heart failure Care Model in Quality Improvement Collaboratives, Health Services Research, Johnson’s, Hempstead, UK.
Asch, S.M. 2005, Does the Collaborative Model Improve Care for Heart Failure? Medical Care, Johnson’s, Hempstead, UK.
R. Mangione, S. 2005, Measuring the Effectiveness of a Collaborative for Quality Improvement in heart failure Care, Does Implementing the Care Model Improve Processes and Outcomes of Care?, Johnson’s, Hempstead, UK.
Vargas, R.B. 2007, ‘Can a heart failure Care Model Collaborative Reduce Heart Disease Risk in Patients with Diabetes?’ Journal of General Internal Medicine, vol.22, no. 2 pp. 215–222.
Homer, C.J. 2005, ‘Impact of a Quality Improvement Program on Care and Outcomes for Children with Asthma’, Archives of Pediatrics and Adolescent Medicine vol 159, no. 5, pp. 464–469.
Chin, M.H. 2002, Improving heart failure Care in Midwest Community Health Centers with the Health Disparities Collaborative, heart failure Care, Hilton, Hilton publications, Kenya.
Basu, R. & Wright, N. 2007. Heart failure disease. Elsevier Publishers. Oxford: UK.
Alysen, B., Patching, R., Oakman, K.M. & Sedorkin, G. 2003, Reporting in a multimedia world, Allen and Unwin, Crows Nest, NSW.
World Health Organization. 2003, Global Strategy on Diet, Physical Activity, and Health, viewed 10 October 2012,
McGlynn, E.A 2003, ‘The Quality of Health Care Delivered to Adults in the United States’, New England Journal of Medicine, no. 26, 2635–2645.
