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eDocTalk article

Congestive heart failure model shows impact <br>of new Legacy/physician collaboration

April 2013

The Legacy Heart Services arrangement is an example of the range of structural models Legacy is pursuing as it partners with physicians.


Legacy Health is changing how it cares for congestive heart failure (CHF) patients. The steps are part of a broad program to deliver top-patient experiences and quality in the region.

In 2011, Legacy entered into a cardiovascular services co-management agreement with Northwest Cardiovascular Institute (NWCI) in order to gain greater leadership and program development expertise.

The cardiac care services line brought together Legacy hospitals, NWCI and Pacific Heart Associates to develop four clinical "pillars" of care: heart failure, rhythms (electrophysiology), coronary artery disease and a medical category.

Early area of emphasis

CHF has received early emphasis, says Sandra Lewis, M.D., of NWCI. Nationally, 29 percent of CHF hospital patients are readmitted within 30 days of their initial discharge. And many CHF outpatients experience inadequate dosing of life-saving drugs.

To address these needs, Legacy formed a comprehensive multi-disciplinary team comprising physicians, nursing staff, pharmacy, technical staff, administration, Information Services and others. It crosses the entire Legacy system with representation from all campuses. (Below is a listing of physician participants.)

Now, Legacy is standardizing care and following American Heart Association/American College of Cardiology guidelines and best practices. The CHF pillar spans the emergency department, hospital course, discharge and outpatient care. In each area, the pillar teams are identifying specific actions and protocols to track and improve care for CHF patients.

Progress will be marked against

  • Heart failure readmission rate
  • Heart failure appropriate care score
  • Development of and compliance with the new system-wide, quality-driven multidisciplinary, best-practices bundle

See a slide set with more on CHF areas of emphasis or contact Sandra J. Lewis, M.D. 

Physicians on the heart failure pillar advisory committee

David Andrews, M.D.
Kevin Breger, M.D.
Celia Dervan, M.D.
Reynaldo Franco, M.D.
Sandeep Garg, M.D.
Nandita Gupta, M.D.
Gordon Johnson, M.D.
Sandra Lewis, M.D.
Hoa Ly, M.D.
Judy Nigro, M.D.
Rob Vissers, M.D.

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