Abstract
Purpose: The purpose of this study was to explore the incidence of palliative care consultations for hospitalized heart failure patients through implementation of a validated risk stratification tool.|Background: Heart failure is a multifaceted, progressive disease affecting over 5 million Americans. This disease process has a poor prognosis with a 50% mortality rate within 5 years of diagnosis. Palliative care consultations are highly underutilized for heart failure patients despite research showing improved quality of life, reduced symptom distress and increased satisfaction. The inpatient setting is a valuable time for healthcare providers to identify high risk for mortality patients and help facilitate a palliative care consultation. Utilization of a validated, risk stratification tool may help standardize this process since the disease trajectory is highly variable.|Sample/Setting: The setting was a 45-bed cardiac unit at a Midwestern healthcare facility. The sample included adult patients admitted to the cardiac floor with a primary diagnosis of heart failure during two 4-month time periods. Retrospectively there were 64 participants and prospectively there were 65 participants.|Methods: The design of the study was a retrospective chart review and a longitudinal pilot research study.|Results: The retrospective chart review demonstrated an overall palliative care consultation incidence of 9% with a palliative care consultation incidence of 20% for patients stratified as high risk. Following implementation of the MAGGIC heart failure risk score paper tool, overall palliative care consultation incidence increased to 15% with a palliative care consultation incidence of 63% for high risk patients. Although clinically significant, there was no statistically significance difference in the palliative consultation rate between any of the risk groups following implementation of the MAGGIC heart failure risk score paper tool.|Conclusions: Implementation of a validated, risk stratification tool for heart failure patients was successfully accomplished on a cardiac unit. Although the sample population was underpowered, it would be beneficial to continue implementation or the tool and collect further data.