Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care

• Published in: Journal of interprofessional care Vol. 31; no. 5; pp. 583 - 592
• Main Authors: Boscart, Veronique M., Heckman, George A., Huson, Kelsey, Brohman, Lisa, Harkness, Karen I., Hirdes, John, McKelvie, Robert S., Stolee, Paul
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.09.2017; Taylor & Francis Ltd
• Subjects: Acute services; Adult; Attitude of Health Personnel; Chronic Disease; Clinical outcomes; Collaboration; Communication; Cooperative Behavior; Disease Management; Female; Fidelity; Health Knowledge, Attitudes, Practice; Heart failure; Heart Failure - therapy; Home health care; Homes for the Aged - organization & administration; Hospitalization; Humans; Inservice Training - organization & administration; Interagency collaboration; Interdisciplinary aspects; interprofessional collaboration; interprofessional communication; Interprofessional Relations; Intervention; Long term health care; long-term care; Male; Morbidity; nursing assistants; Nursing homes; Nursing Homes - organization & administration; Patient Care Team - organization & administration; Pilot Projects; Professional Role; Qualitative Research; Quality of Health Care - organization & administration; Sustainability; Teams; unregulated care providers; Heart failure; teams; interprofessional communication; long-term care; unregulated care providers; nursing assistants; interprofessional collaboration
• ISSN: 1356-1820; 1469-9567
• DOI: 10.1080/13561820.2017.1340875

Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.