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Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care
Authors:Veronique M Boscart  George A Heckman  Kelsey Huson  Lisa Brohman  Karen I Harkness  John Hirdes
Institution:1. Conestoga College Institute of Technology and Advanced Learning, Kitchener, Ontario, Canada;2. Research Institute for Aging and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;3. Colleges in Seniors Care, Conestoga College Institute of Technology and Advanced Learning, School of Health &4. Life Sciences and Community Services, Kitchener, Ontario, Canada;5. Sunnyside Home Seniors’ Services, Kitchener, Ontario, Canada;6. McMaster University, Clinical Lead, Heart Failure and Cardiovascular Chronic Disease Management, Cardiac Care Network, Hamilton Health Sciences, Hamilton, Ontario, Canada;7. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
Abstract: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.
Keywords:Heart failure  interprofessional collaboration  interprofessional communication  long-term care  nursing assistants  teams  unregulated care providers
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