{"id":7396,"date":"2022-11-07T00:00:00","date_gmt":"2022-11-07T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/news-releases\/decision-support-tool-used-in-the-emergency-department-reduces-rates-of-death-or-hospitalization-after-heart-failure\/"},"modified":"2023-06-14T18:15:45","modified_gmt":"2023-06-14T22:15:45","slug":"decision-support-tool-used-in-the-emergency-department-reduces-rates-of-death-or-hospitalization-after-heart-failure","status":"publish","type":"news_release","link":"https:\/\/www.ices.on.ca\/fr\/news-releases\/decision-support-tool-used-in-the-emergency-department-reduces-rates-of-death-or-hospitalization-after-heart-failure\/","title":{"rendered":"Decision support tool used in the emergency department reduces rates of death or hospitalization after heart failure"},"content":{"rendered":"<p>A tool that emergency department clinicians can use to guide hospital admission or discharge decisions for heart failure patients reduces 30-day all-cause death or cardiovascular hospitalization by 12 per cent, according to a new trial from the Peter Munk Cardiac Centre (PMCC) at University Health Network (UHN), <strong>ICES<\/strong>, and the Ted Rogers Centre for Heart Research.<\/p>\n<p>\nThe validated tool, which was developed using data analytics, helps hospital staff to ascertain whether heart failure patients fall into low-, intermediate-, or high-risk categories, which can then inform the decision to admit a patient to hospital or discharge with follow-up care.<\/p>\n<div>\n<div class=\"download-section alignwide infographic-download\" id=\"block_16af910e42184d9468ebe72b502c3e08\" data-style=\"deep-blue\">\n\t<div class=\"download-section-content\">\n\t\t\t\t<h2>\n\t\t\tInfographic\t\t<\/h2>\n\t\t\n\t\t\t<\/div>\n\t<div class=\"download-section-buttons\">\n\t\t\t\t\t\t<a class=\"download-section-buttons-primary\" href=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/03\/Lee-Decision-Support-Tools.png\" target=\"_blank\"\n\t\t\tdownload\t\t\taria-label=\"Download Infographic (opens in a new tab)\"\t\t>\n\t\t\tDownload Infographic\t\t\t<svg width=\"19\" height=\"19\" viewBox=\"0 0 19 19\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" role=\"presentation\">\n<path d=\"M2.78003 18.8301C2.14282 18.8301 1.59713 18.603 1.14297 18.1488C0.688813 17.6947 0.46212 17.1494 0.462893 16.5129V13.0372H2.78003V16.5129H16.6829V13.0372H19V16.5129C19 17.1502 18.7729 17.6958 18.3188 18.15C17.8646 18.6042 17.3193 18.8308 16.6829 18.8301H2.78003ZM9.73145 14.1958L3.9386 8.40295L5.5606 6.72303L8.57288 9.73531V0.292969H10.89V9.73531L13.9023 6.72303L15.5243 8.40295L9.73145 14.1958Z\" fill=\"#151D5D\"\/>\n<\/svg>\n\t\t<\/a>\n\t\t\n\t\t\t\t\t\t\t\t\t\t<button type=\"button\" class=\"download-section-buttons-secondary\" data-infographic-popup-open=\"block_16af910e42184d9468ebe72b502c3e08-infographic-popup\" aria-haspopup=\"dialog\">\n\t\t\t\tClick to View\t\t\t<\/button>\n\t\t\t\t\t\t<\/div>\n\n\t\t<div class=\"infographic-popup\" id=\"block_16af910e42184d9468ebe72b502c3e08-infographic-popup\" role=\"dialog\" aria-modal=\"true\" aria-label=\"Infographic\" hidden>\n\t\t<div class=\"infographic-popup-overlay\" data-infographic-popup-close><\/div>\n\t\t<div class=\"infographic-popup-container\">\n\t\t\t<button type=\"button\" class=\"infographic-popup-close\" data-infographic-popup-close aria-label=\"Close infographic\">&times;<\/button>\n\t\t\t<img decoding=\"async\" class=\"infographic-popup-image\" src=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/03\/Lee-Decision-Support-Tools.png\" alt=\"Infographic\">\n\t\t<\/div>\n\t<\/div>\n\t<\/div>\n<\/div>\n<p>\nThe randomized trial, published in the <em>New England Journal of Medicine<\/em>, included 10 hospitals and 5,452 patients in Ontario, Canada, and assigned hospitals to usual care (when clinicians use their clinical judgement to guide decisions) followed by a cross-over to the use of the tool. The study was made possible through funding from the Ontario SPOR SUPPORT Unit (OSSU).<\/p>\n<p>\nThe study comes as hospitals grapple with overcrowding and staffing shortages and suggests that heart failure patients at lower risk of adverse events can be discharged from the emergency department or following a short hospital stay&#x2014;with rapid follow-up care in place.<\/p>\n<p>\n&quot;Heart failure places a substantial health burden on patients and increases healthcare utilization and costs,&quot; says lead author <a href=\"\/ices-scientists\/douglas-lee\/\">Dr. Douglas Lee<\/a>, staff cardiologist at the Peter Munk Cardiac Centre at UHN, Ted Rogers Chair in Heart Function Outcomes at the Ted Rogers Centre for Heart Research (TRCHR), and senior scientist at ICES. &quot;We need new approaches to improve the care that we deliver to patients with heart failure who come to the emergency department, and the strategy that we tested may be a step toward achieving this goal.&quot;<\/p>\n<p>\nThe tool is used to support clinicians&#x2019; decision-making about who should be hospitalized and who can be discharged home early, with provision of a rapid follow-up visit at a clinic staffed by a nurse and supervised by a cardiologist.&#xa0;<\/p>\n<p>\nResearchers found that the hospital-based strategy for decision support was associated with:&#xa0;<\/p>\n<ul class=\"list-style\">\n<li>A 12 per cent reduction in the rate of all-cause death or cardiovascular hospitalization over 30 days.<\/li>\n<li>A decrease in the rate death or cardiovascular hospitalization over a 20-month follow-up.<\/li>\n<li>Fewer than six deaths or all-cause hospitalizations for low-risk and intermediate-risk patients who were discharged from hospital until they could be seen by a doctor in the outpatient clinic.<\/li>\n<\/ul>\n<p>\n&#x201c;It has always been our goal to ensure that we provide the right care, for the right patient, at the right time,&#x201d; says senior author Dr. Heather Ross, scientific lead, Ted Rogers Centre for Heart Research, and division head, cardiology, at the Peter Munk Cardiac Centre at the University Health Network. &#x201c;This diagnostic tool will have an immense impact, not just on patients and families, but on the whole of the healthcare system.&#x201d;<\/p>\n<p>\nThe study, &#x201c;Trial of an intervention to improve acute heart failure outcomes&#x201d; was published in the <em>New England Journal of Medicine<\/em>. The study was supported by ICES and was funded by the Ontario SPOR Support Unit, the Ted Rogers Centre for Heart Research, and the Canadian Institutes of Health Research.&#xa0;<\/p>\n<p><em><br \/>\nAuthor block: Lee DS, Straus SE, Farkouh ME, Austin PC, Taljaard M, Chong A, Fahim C, Poon S, Peter Cram P, Smith S, McKelvie RS, Porepa L, Hartleib M, Mitoff P, Iwanochko RM, MacDougall A, Shadowitz S, H Abrams, Elbarasi E, Fang J, Udell JA, Schull MJ, Mak S, Ross HJ, on behalf of the COACH Trial investigators.<\/em><\/p>\n<p><strong><br \/>\nThe Peter Munk Cardiac Centre (PMCC)<\/strong> opened in 1997 through the generous support of Peter and Melanie Munk. A global leader in cardiovascular care, with internationally-renown medical expertise, PMCC has some of the best patient outcomes in the world and is home to many world firsts that span cardiac and vascular research and discoveries. Canada&apos;s premier cardiac centre is part of the University Health Network (UHN) and located at the Toronto General Hospital, and the Toronto Western Hospital, in Toronto, Ontario, Canada. For more information, visit: <a href=\"http:\/\/www.petermunkcardiaccentre.ca\" title=\"opens external link\">www.petermunkcardiaccentre.ca<\/a><\/p>\n<div><div class=\"about-ices-shortcode\"><p><strong>ICES<\/strong> is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: <a href=\"https:\/\/twitter.com\/ICESOntario\" target=\"_blank\" rel=\"noopener\">@ICESOntario<\/a><\/p>\n<\/div><\/div>\n<p>\nThe <strong>Ted Rogers Centre for Heart Research<\/strong>, founded in 2014, has the mission is to transform and dramatically improve the future of heart health for children, adults and families across Canada and around the world, through an integrated program of outstanding research, education, and clinical care. At the Ted Rogers Centre for Heart Research, pre-eminent experts in a variety of disciplines including cardiology, bioengineering, computer science, cell biology, pediatrics, nursing, genomic medicine, and immunology work together to accelerate the discovery of new approaches to treating heart failure. A model for collaborative medicine, it has reaffirmed Toronto as a global hub for cutting-edge cardiovascular research. <a href=\"http:\/\/www.tedrogersresearch.ca \" title=\"opens external ink\">www.tedrogersresearch.ca&#xa0;<\/a><\/p>\n<h2>\nFOR FURTHER INFORMATION PLEASE CONTACT:<\/h2>\n<p>\nMisty Pratt<br \/>\nSenior Communications Officer, ICES<br \/>\n<a href=\"mailto:Misty.Pratt@ices.on.ca\">Misty.Pratt@ices.on.ca<\/a><br \/>\n613-882-7065<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A tool that emergency department clinicians can use to guide hospital admission or discharge decisions for heart failure patients reduces 30-day all-cause death or cardiovascular hospitalization by 12 per cent, according to a new trial from the Peter Munk Cardiac Centre (PMCC) at University Health Network (UHN), ICES, and the Ted Rogers Centre for Heart [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,40,63,66],"class_list":["post-7396","news_release","type-news_release","status-publish","hentry","topic-acute-and-emergency-services","topic-cardiovascular-disease","topic-decision-science","topic-trials"],"acf":{"infographic":[9278],"journal_article":[1753],"research_report":[],"atlas":[],"research_program":[6742],"site":[6733],"ices_scientist":[1290],"announce_or_event":[],"video":[],"iitn_type":false,"iitn_title":"Assessing the risks: How a new scorecard is helping emergency doctors better assess risk in heart failure patients","iitn_short_title":"","iitn_source_link_url":"https:\/\/cihr-irsc.gc.ca\/e\/53160.html","iitn_source_link_text":"CIHR","sitecore_item_id":"64F39ACA-7D88-4367-8ACA-665008571846","sitecore_item_name":"Decision-support-tool-used-in-the-emergency-department-reduces-rates-of-death-or-hospitalization","sitecore_field_values":"{\n  \"Content\": \"<p>A tool that emergency department clinicians can use to guide hospital admission or discharge decisions for heart failure patients reduces 30-day all-cause death or cardiovascular hospitalization by 12 per cent, according to a new trial from the Peter Munk Cardiac Centre (PMCC) at University Health Network (UHN), <strong>ICES<\/strong>, and the Ted Rogers Centre for Heart Research.<\/p>n<p>nThe validated tool, which was developed using data analytics, helps hospital staff to ascertain whether heart failure patients fall into low-, intermediate-, or high-risk categories, which can then inform the decision to admit a patient to hospital or discharge with follow-up care.<\/p>n<p><a href=\"~\/media\/6ADA1D6C9EDF4AAAB019D1A41D7900CE.ashx\" onclick=\"_gaq.push(['_trackEvent','Download', 'Lee-Decision-Support-Tools-Infographic-November2022', this.href]);\"><img height=\"462\" alt=\"Heart failure patients have lower rates of death and hospitalization when physicians use decision support tools to guide clinical decision-making\" width=\"350\" src=\"~\/media\/54CB6558D621438EAF4BB78D19355A49.ashx\" \/><\/a><span class=\"grey\" style=\"font-size: 12px; font-weight: bold; display: block; color: #5b5656;\">Click image to enlarge<\/span><\/p>n<p>nThe randomized trial, published in the <em>New England Journal of Medicine<\/em>, included 10 hospitals and 5,452 patients in Ontario, Canada, and assigned hospitals to usual care (when clinicians use their clinical judgement to guide decisions) followed by a cross-over to the use of the tool. The study was made possible through funding from the Ontario SPOR SUPPORT Unit (OSSU).<\/p>n<p>nThe study comes as hospitals grapple with overcrowding and staffing shortages and suggests that heart failure patients at lower risk of adverse events can be discharged from the emergency department or following a short hospital stay&mdash;with rapid follow-up care in place.<\/p>n<p>n\"Heart failure places a substantial health burden on patients and increases healthcare utilization and costs,\" says lead author <a href=\"~\/link.aspx?_id=CEEE13ADC7DE455FACF8AAD7D27BB178&amp;_z=z\">Dr. Douglas Lee<\/a>, staff cardiologist at the Peter Munk Cardiac Centre at UHN, Ted Rogers Chair in Heart Function Outcomes at the Ted Rogers Centre for Heart Research (TRCHR), and senior scientist at ICES. \"We need new approaches to improve the care that we deliver to patients with heart failure who come to the emergency department, and the strategy that we tested may be a step toward achieving this goal.\"<\/p>n<p>nThe tool is used to support clinicians&rsquo; decision-making about who should be hospitalized and who can be discharged home early, with provision of a rapid follow-up visit at a clinic staffed by a nurse and supervised by a cardiologist.&nbsp;<\/p>n<p>nResearchers found that the hospital-based strategy for decision support was associated with:&nbsp;<\/p>n<ul class=\"list-style\">n    <li>A 12 per cent reduction in the rate of all-cause death or cardiovascular hospitalization over 30 days.<\/li>n    <li>A decrease in the rate death or cardiovascular hospitalization over a 20-month follow-up.<\/li>n    <li>Fewer than six deaths or all-cause hospitalizations for low-risk and intermediate-risk patients who were discharged from hospital until they could be seen by a doctor in the outpatient clinic.<\/li>n<\/ul>n<p>n&ldquo;It has always been our goal to ensure that we provide the right care, for the right patient, at the right time,&rdquo; says senior author Dr. Heather Ross, scientific lead, Ted Rogers Centre for Heart Research, and division head, cardiology, at the Peter Munk Cardiac Centre at the University Health Network. &ldquo;This diagnostic tool will have an immense impact, not just on patients and families, but on the whole of the healthcare system.&rdquo;<\/p>n<p>nThe study, &ldquo;Trial of an intervention to improve acute heart failure outcomes&rdquo; was published in the <em>New England Journal of Medicine<\/em>. The study was supported by ICES and was funded by the Ontario SPOR Support Unit, the Ted Rogers Centre for Heart Research, and the Canadian Institutes of Health Research.&nbsp;<\/p>n<p><em>nAuthor block: Lee DS, Straus SE, Farkouh ME, Austin PC, Taljaard M, Chong A, Fahim C, Poon S, Peter Cram P, Smith S, McKelvie RS, Porepa L, Hartleib M, Mitoff P, Iwanochko RM, MacDougall A, Shadowitz S, H Abrams, Elbarasi E, Fang J, Udell JA, Schull MJ, Mak S, Ross HJ, on behalf of the COACH Trial investigators.<\/em><\/p>n<p><strong>nThe Peter Munk Cardiac Centre (PMCC)<\/strong> opened in 1997 through the generous support of Peter and Melanie Munk. A global leader in cardiovascular care, with internationally-renown medical expertise, PMCC has some of the best patient outcomes in the world and is home to many world firsts that span cardiac and vascular research and discoveries. Canada's premier cardiac centre is part of the University Health Network (UHN) and located at the Toronto General Hospital, and the Toronto Western Hospital, in Toronto, Ontario, Canada. For more information, visit: <a href=\"http:\/\/www.petermunkcardiaccentre.ca\" title=\"opens external link\">www.petermunkcardiaccentre.ca<\/a><\/p>n<p><em><span style=\"color: #002060;\">ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter:<\/span> <a href=\"https:\/\/twitter.com\/ICESOntario\">@ICESOntario<\/a><\/em><\/p>n<p>nThe <strong>Ted Rogers Centre for Heart Research<\/strong>, founded in 2014, has the mission is to transform and dramatically improve the future of heart health for children, adults and families across Canada and around the world, through an integrated program of outstanding research, education, and clinical care. At the Ted Rogers Centre for Heart Research, pre-eminent experts in a variety of disciplines including cardiology, bioengineering, computer science, cell biology, pediatrics, nursing, genomic medicine, and immunology work together to accelerate the discovery of new approaches to treating heart failure. A model for collaborative medicine, it has reaffirmed Toronto as a global hub for cutting-edge cardiovascular research. <a href=\"http:\/\/www.tedrogersresearch.ca \" title=\"opens external ink\">www.tedrogersresearch.ca&nbsp;<\/a><\/p>n<h2>nFOR FURTHER INFORMATION PLEASE CONTACT:<\/h2>n<p>nMisty Pratt<br \/>nSenior Communications Officer, ICES<br \/>n<a href=\"mailto:Misty.Pratt@ices.on.ca\">Misty.Pratt@ices.on.ca<\/a><br \/>n613-882-7065<\/p>\",\n  \"Title\": \"Decision support tool used in the emergency department reduces rates of death or hospitalization after heart failure\",\n  \"Short title\": \"Decision support tool used in the\",\n  \"Teaser image\": \"<image mediaid=\"{A322F4BD-074D-4BD9-A21A-A9A358DE2CFF}\" alt=\"&quot;&quot;\" height=\"\" width=\"\" hspace=\"\" vspace=\"\" \/>\",\n  \"Summary\": \"A tool that ED clinicians can use to guide hospital admission or discharge decisions for heart failure patients reduces 30-day all-cause death or cardiovascular hospitalization by 12 per cent.\",\n  \"Location\": \"Toronto\",\n  \"In The News\": \"{8249E18C-8DE7-4AB2-A5F0-93061E81A504}\",\n  \"ICES Scientists\": \"{CEEE13AD-C7DE-455F-ACF8-AAD7D27BB178}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"Posted Date\": \"20221107T000000\",\n  \"Publication Link\": \"<link text=\"Abstract\" linktype=\"internal\" title=\"opens related abstract\" querystring=\"\" target=\"\" id=\"{FB8C9E89-CAA0-433B-8730-454486933877}\" \/>\",\n  \"Related Link\": \"<link text=\"ICES in the News | CIHR\" linktype=\"external\" url=\"https:\/\/cihr-irsc.gc.ca\/e\/53160.html\" anchor=\"\" title=\"opens external link\" target=\"\" \/>\",\n  \"Related Link2\": \"<link text=\"Infographic\" linktype=\"external\" url=\"~\/Publications\/Infographics?year=2022&amp;page=1#Lee-Decision-Support-Tools\" anchor=\"\" title=\"opens related infographic\" target=\"\" \/>\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Newsroom\/News-Releases\/2022\/Decision-support-tool-used-in-the-emergency-department-reduces-rates-of-death-or-hospitalization"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Decision support tool used in the emergency department reduces rates of death or hospitalization after heart failure<\/title>\n<meta name=\"description\" content=\"A tool that emergency department clinicians can use to guide hospital admission or discharge decisions for heart failure patients reduces 30-day all-cause\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/news-releases\/decision-support-tool-used-in-the-emergency-department-reduces-rates-of-death-or-hospitalization-after-heart-failure\/\" \/>\n<meta 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