Examples of what has been done

Heart failure care pathway developed in consultation with patients

Overview

A group of experts from the university of Santiago de Compostela in Galicia, Spain, developed an HF care pathway to try to ensure all patients with HF receive consistent and continuous care across their entire care journey. The pathway was developed specifically for Galicia, with input from HF patients as well as different health professionals involved in the HF care pathway.

What they did

The expert group developed a pathway of care that reflects existing clinical guideline recommendations, but also takes into account local resources and service delivery models. They also used the findings of two focus groups to help identify existing gaps in the delivery of care which are then addressed in the proposed care pathway. One focus group included HF patients and their caregivers, the other included all relevant professionals involved in the care of HF patients both in-hospital and in the community.

The pathway provides a detailed outline of the ideal delivery of care in hospital, starting with within the emergency room, as well as after patients’ discharge into the community. It places a lot of emphasis on the need for appropriate follow up care, and the need to develop appropriate care roles (e.g. through specialist HF nurses) to provide continuous therapeutic education and information for patients after their discharge from hospital.