Current Emergency Department Disposition of Patients With Acute Heart Failure: An Opportunity for Improvement

Dana R Sax; Dustin G Mark; Jamal S Rana; Mary E Reed; Joann Lindenfeld; Lynne W Stevenson; Alan B Storrow; Javed Butler; Peter S Pang; Sean P Collins

doi:10.1016/j.cardfail.2022.05.006

Current Emergency Department Disposition of Patients With Acute Heart Failure: An Opportunity for Improvement

J Card Fail. 2022 Oct;28(10):1545-1559. doi: 10.1016/j.cardfail.2022.05.006. Epub 2022 May 29.

Authors

Affiliations

¹ Department of Emergency Medicine, Kaiser Permanente Northern California, Oakland and Richmond Medical Centers, Oakland, California; Division of Research, Kaiser Permanente Northern California, Oakland, California. Electronic address: danar.sax@kp.org.
² Department of Emergency Medicine, Kaiser Permanente Northern California, Oakland and Richmond Medical Centers, Oakland, California; Division of Research, Kaiser Permanente Northern California, Oakland, California.
³ Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Cardiology, Kaiser Permanente Northern California, Oakland and Richmond Medical Centers, Oakland, California.
⁴ Division of Research, Kaiser Permanente Northern California, Oakland, California.
⁵ Department of Cardiology, Vanderbilt University Medical Center, Vanderbilt, Tennesee.
⁶ Department of Emergency Medicine, Vanderbilt University Medical Center, Vanderbilt, Tennesee.
⁷ Department of Cardiology, University of Mississippi, Jackson, Mississippi.
⁸ Department of Emergency Medicine, Indiana University, Indianapolis, Indiana.

PMID: 35649474
DOI: 10.1016/j.cardfail.2022.05.006

Abstract

Emergency department (ED) providers play a critical role in the stabilization and diagnostic evaluation of patients presenting with acute heart failure (AHF), and EDs are key areas for establishing current best practices and future considerations for the disposition of and decision making for patients with AHF. These elements include accurate risk assessment; response to initial treatment and shared decision making concerning optimal venue of care; reframing of physicians' risk perceptions for patients presenting with AHF; exploration of alternative venues of care beyond hospitalization; population-level changes in demographics, management and outcomes of HF patients; development and testing of data-driven pathways to assist with disposition decisions in the ED; and suggested outcomes for measuring success.

Keywords: Emergency department; alternative venues of care; risk stratification; risk tolerance; shared decision making.

Publication types

Review
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Acute Disease
Emergency Service, Hospital
Heart Failure* / diagnosis
Heart Failure* / epidemiology
Heart Failure* / therapy
Hospitalization
Humans
Risk Assessment