This project aims to learn how to effectively monitor patients with heart failure in nursing facilities. Patients’ symptom experience is at the cornerstone of heart failure care. Patients often experience multiple symptoms simultaneously, and a change in symptoms can indicate impending heart failure decompensation. Patients with heart failure can have difficulty recognizing and attributing their symptoms to heart failure. Previous hospitalization for heart failure does not improve the patient’s ability to recognize or respond to symptoms.
Monitoring patients effectively allows nursing facility staff to intervene earlier and potentially avoid a hospitalization. Our previous work has demonstrated the following: patients in nursing facilities are infrequently and inconsistently monitored for signs and symptoms of heart failure; identification of heart failure decompensation is frequently missed in the early stages; and patients in nursing facilities are not always willing to participate in monitoring, especially when it comes to having their weight measured. During the Pipeline to Proposal Independent Tier III project period we will
- Discern barriers for systems, staff, and patients to monitoring of weight and symptoms. We will do so by conducting key informant interviews and focus groups.
- Develop protocols for heart failure monitoring in nursing facilities to answer our comparative clinical effectiveness research question. These protocols will be informed by multiple perspectives from patients, patient-caregiver dyads, and our long-term care stakeholder advisory board.
- Determine which facilities are appropriate for the heart failure intervention and the terms of engagement for participating nursing facilities with guidance from our Colorado Medical Directors Association partners.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.