Managing Care for Heart Failure Patients
MaineHealth aims to help people with heart failure have the best possible clinical outcomes and quality of life. To achieve this, MaineHealth organizations and partners implement a variety of evidence-based treatments across the MaineHealth regions and in every care setting in order to provide care as close to home as possible. This approach helps patients manage heart failure symptoms better; as a result, they need to be hospitalized less often.
- Care settings include patients’ private homes, nursing care facilities, medical care offices, emergency departments and hospitals.
- Treatment options include evidence-based clinical pathways, supporting clinical decision tools, providing patients with a clear and consistent plan of care (including how to best care for themselves), and very specialized care for patients with advanced disease.
Clinical Strategies to Support Heart Failure Patients
The MaineHealth Heart Failure Protocol for Skilled Nursing Facilities uses a “high touch” approach to improve care for the many heart failure patients who benefit from care in these facilities. All nursing facility staff, from physicians to nursing assistants, are trained to recognize changes that might lead to worsening symptoms and then to respond without delay following proven guidelines. The result is more patients feeling better and staying out of the hospital.
Thirty-seven skilled nursing facilities throughout MaineHealth communities have been trained and are working toward implementing this low-technology, “high touch” improvement in the care of heart failure patients.
Most Maine hospitals can adequately care for patients with mild to moderate symptoms of heart failure. Maine Medical Center has developed the expertise and resources to care for patients with the most severe stages of the disease, when symptoms of fatigue and shortness of breath can be debilitating. Examples of this advanced technology include:
Left Ventricular Assist Device (LVAD)
- An LVAD is a pump that is surgically implanted into patients with severe heart failure when it appears that the heart is not going to recover.
- Some LVAD patients have been on this support for up to seven years.
- LVAD devices can result in dramatically better quality of life, giving people the chance to return home with less fatigue, more strength, better breathing, and a longer life.
- Since 2014 Maine Medical Center has implanted 24 LVADs.
- Data from national registries indicate that Maine Medical Center performance (actual vs. expected mortality) for LVAD implantations are better than expected.
Extracorporeal Membrane Oxygenation (ECMO)
- ECMO is a pump that does the work of the heart and lungs, giving these organs a rest when someone is recovering from a large heart attack or other critical conditions.
- A patient on ECMO stays in the critical care unit until they can survive without the need for ECMO.
- Since 2014, Maine Medical Center has used the ECMO technology to benefit 46 patients (98 patients since 1996).
- The national Extracorporeal Life Support Organization recently awarded Maine Medical Center with the Award for Excellence in Extracorporeal Life Support.