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Granger and Shah comment on AHA statement

March 20, 2012

AHA recently released an article explaining the importance of teamwork therapy for patients with heart failure. 

The article stated that “clinicians should engage their advanced heart failure patients in the process of shared decision making”. However, the article also outlined some of the major barriers for doing so, including, time, resources, training, and reimbursement.

When asked to comment, Bradi Granger, PhD, and Bimal Shah, MD, said:

"As part of the care redesign initiative in the Duke Heart Center, patients with heart failure are receiving innovative evidence based care that integrates multidisciplinary teamwork to address patient preferences in decision making for advanced heart failure. This Duke approach is consistent with recent recommendations made in the AHA scientific statement published in Circulation by Dr. Larry Allen and colleagues, which provides supporting evidence for the benefits of regular communication with patients at every visit. The Duke approach recognizes the importance of not simply “telling” patients about treatment options, but also listening to patient goals, and documenting and designing a long-term plan for care that integrates patient and family goals and priorities as the central focus. In addition, the Duke Heart Failure program is studying innovative approaches to teamwork and collaboration in palliative care options for advanced heart failure. A new five year grant sponsored by the National Institute for Nursing Research and led by Dr. Joseph Rogers and Dr. James Tulsky is designed to study patient-centered palliative care interventions. As part of this study, patients are able to hear from their doctors directly about their current condition, goals of care, treatment options, and overall prognosis. A multidisciplinary care team then works to implement strategies to listen, document, and communicate across providers and care settings, including home care and hospice, what the patient perceived priorities and needs are, and how the patient and family can best be engaged as partners in this conversation. In every aspect of advanced heart failure care at Duke, patients and families play an increasingly central role in making appropriate and shared decisions about their health and HF treatment."

To read the full article on MedPage Today, click here.

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