Nathan Adelson Hospice is part of The National Partnership for Healthcare and Hospice Innovation’s (NPHI) cross-industry, Advanced Cardiac Care Program. 

Heart failure is a chronic progressive disease and has the potential for high-quality home-based care. However, despite the prevalence of heart failure, it is the most common cause of death for which the utilization of hospice is both late in the course of the disease and extremely low, especially when being discharged from the hospital after an acute exacerbation. Research reveals that only 5 percent of end-stage heart failure patients are referred to hospice or palliative care after hospitalization. As a result, thousands of patients with advanced cardiovascular disease and their families, do not have the opportunity to experience the high-quality care, support and compassion that a hospice or advance illness care program can provide with a particular focus on care in the home. 

As heart disease remains a top cause of death in the United States, the NPHI protocols will be critical resources to those who prefer to receive care in the comfort of their home environment. 

Many advanced congestive heart failure patients often receive care in later stages of the disease, often too late to enhance quality of life, simply due to underutilized services demonstrated to improve care quality.

“We believe no one should end the journey of life alone, afraid or in pain,” said Nathan Adelson Hospice President & CEO Karen Rubel. “By participating in this program, we are able to equip both our inpatient and at-home care nurses with vital information and protocols in caring for our community members with advanced heart disease, and hopefully prevent frequent or lengthy hospital stays. This initiative is just one of the many benefits that Nathan Adelson Hospice offers to our community, patients and their loved ones.”

According to Cameron Muir, M.D., FAAHPM, Chief Innovation Officer for NPHI, the collaboration with the nation’s leading experts in cardiac care, palliative care and advanced illness, the guidelines being developed will provide clarity and access to critical insights, clinical protocols and resources that are urgently needed to address devastating gaps in care.

“Far too many Americans die alone in hospitals from heart failure because too often, clinicians and patients – particularly minority patients – are not made aware of how not-for-profit hospice and  advanced illness care organizations can provide affordable quality care at home,” Muir said.

Together with national and community partners, we are working to better understand the needs of our community, patients, family members, and clinicians to develop evidence-based tools that improve care quality, communication, and costs. 

Our aim with the Advanced Cardiac Care program is three-fold: 

  1. Increasing Access and Awareness: We seek to ensure high quality care and support for all who live with advanced heart failure and cardiac disease and that there is broad awareness that these services are available, especially in their homes. The vast majority of Americans want to receive advanced illness care in their homes ( experiences-with-end-of-life-medical-care-in-the-us-findings/) and yet, most receive care and even end of life care in the hospital. We seek to support efforts to help people to articulate their healthcare wishes and ensure that the care that they receive is goal oriented. In this process, we must also pay particularly close attention to those that have been historically and currently impacted by various disparities. 
  2. Addressing disparities in care: The prevalence of heart disease is greater and presents with more serious outcomes among African American/Black populations. Further, Hispanic American and Asian Americans populations, also have increased risk factors leading to heart disease. In home care options provided by our programs are also less known amongst these communities. With this initiative, we have a unique opportunity to address these disparities and raise health equity by being attentive and considerate of the specific culture, religious, racial, social, and environmental distinctions and drivers that impact the outcomes of care. 
  3. Impact of COVID-19: Underlying cardiovascular disease is a significant risk factor for complications and death related to COVID19. Those that are hospitalized with COVID-19 with cardiovascular disease are twice as likely to die as those without the complication.