Implementation of a Specialized Heart Function Inpatient Unit to Improve Patient Care, Trainee Education, and Healthcare System Efficiencies

A BSTRACT Background: Heart failure is an increasingly prevalent condition characterized by long length of stays (LOSs) in hospital and high 30-day readmission rates. To accommodate the growing number of patients, a new specialized heart function inpatient unit (HFIU) was implemented to allow dedicated personnel trained in heart failure management. The HFIU aimed to improve staff satisfaction and reduce LOS and 30-day readmissions. We report this initial evaluation at a cardiac center in Hamilton, ON. Methods and Design: The HFIU service had a capacity of 7–10 beds and was staffed by a cardiologist and nurse practitioner trained in heart failure management. Online surveys were administered at 3- and 12-month postimplementation to all staff involved, using a 7-point Likert scale. In addition, patient metrics for 6-month preimplementation and 12-month postimplementation were reviewed from a hospital database, including LOS and 30-day readmission rates. Results: Staff expressed satisfaction with the HFIU at 12-month postimplementation on 7-point Likert scale with mean responses of 5.40 (standard deviation [SD] =1.07) for physicians ( n = 10) and 5.50 (SD = 1.13) for nurses ( n = 11). The median LOS was 8.3 days (interquartile range [IQR] =0.75) versus 7.70 days (IQR = 2, Z = −0.52, P = 0.6), and readmission rate was 21% vs. 19% (t (7) = −0.64, P = 0.62) in the pre- versus post implementation groups. Conclusions: The HFIU enabled focused and dedicated heart failure care. Staff satisfaction and a trend of reduced mortality rate (23% vs. 5%, P = 0.04) in the postimplementation group were observed. These results indicate a potential benefit in considering the implementation and further evaluation of specialized units in the care of heart failure patients.