The CHP HF GAP Partnership

The CHP HF GAP Partnership oversees strategic direction, engages clinical and management leadership participation (especially cardiologists and primary care physicians), and provides guidance on how best to incorporate HFSA and ACC/AHA HF guidelines and quality measurement more consistently and effectively into HF care in both inpatient and outpatient settings. The structure and characteristics of the Partnership have been previously described in detail. Recent activity has focused on regular direct communication and engagement of several regional and national organizations, including:

The national and regional offices of the American Heart Association (AHA)
The American College of Cardiology (ACC)
Ohio Department of Health (ODH)
Ohio Hospital Association (OHA)
The American Medical Association (AMA)
The National Heart Failure Training Program (“NHeFT”)
Various large cardiologist groups across the state of OH
Several large health systems

These relationships are focused on garnering support, participation, evaluation and dissemination of the activities of the CHP HF GAP initiative in the interest of long-range sustainability of the program.

One important enhancement to the CHP HF GAP initiative is the development of a special training curriculum developed for a broad range of HF caregivers in conjunction with N-HeFT. This program is based upon experience with the curriculum designed for the HF Advocates and will be led by Dr. Ileana Piña and Jeanne Hitch and supported by the other HF GAP Co-Investigators as well as the Advocates themselves.

Within its framework of 33 host sites across the nation, The National Heart Failure Training Program is well-poised to disseminate the HF Advocate role. Working closely with GAP partners such as Susan Bennett, DNS, RN and Robin Trupp, MSN, APRN,BC, CCRN, CCRC, Margie Namie, RN, BSN, MPH, CPHQ and the HF Advocates N-HeFT leadership has evaluated the training provided to the HF Advocates and made adjustments based on feedback received. Three hospitals within the Catholic Healthcare Partners Mercy System in the Cincinnati area have hired their HF Advocates. They will attend training as a group May 22, 23 at the N-HeFT site in Cincinnati which will focus on the clinical aspects of their position. Based on feedback received from current advocates, we have strengthened the training and reinforced areas of perceived weakness such as end-of life and data management. We are in the process of taping the didactic portion of the training which will serve as reinforcement and help us to expand to a broader audience. In addition we have created a workbook to help them plan their activities and they will have access to all the tools created by the pilot group. Part of their plan includes a career development component where they will select opportunities to increase their clinical and management knowledge and skills. Furthermore, all five HF Advocates have offered to mentor the newly hired group. They also have access to the expertise provided by the partners and furthered in the OHFC. See appendix for training outline and initial agenda.

In three months, the Advocates will return with the physician champions to further their training where they will focus on systems management. Meanwhile utilizing lessons learned from the original GAP and feedback from the new advocates, we will develop a manual to include a detailed application process. Training for hospital administrators will also be offered.

The program is expanding to other disease states in hospitals that have seen successful outcomes as a result of advocate efforts. For example, St. Rita Medical Center in Lima has hired an Advocate to manage diabetes care. Also, hospitals outside of CHP have shown interest in initiating the HF Advocate position such as St. Joseph Hospital in New Jersey and Brown Memorial in Lake County Ohio. N-HeFT is also expanding its training efforts by partnering with groups to develop pilot training programs for nursing homes, home health care agencies, and hospice groups to improve care along the continuum of care for heart failure.