Integrated, collaborative palliative care in heart failure: the St. George Heart Failure Service experience 1999-2002.

Patricia M Davidson, Glenn Paull, Kate Introna, Jill Cockburn, Jan Maree Davis, David Rees, David Gorman, Linda Magann, Mary Lafferty, Kathleen Dracup

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BACKGROUND: Chronic heart failure (HF) is the only heart condition increasing in prevalence and is primarily a condition of aging. This condition has outcomes worse than many cancers; however, patients are often denied the benefits of palliative care with its important emphasis on symptom management, spirituality, and emotional health and focus on family issues. AIM: To describe the development of a model of an integrated, consultative, palliative care approach within a comprehensive HF community-focussed disease management program. METHOD: A collaborative model was developed following a systematic needs assessment and documentation of local resources. Principles underpinning this model were based upon fostering of communication, consultancy, and skill development. Within this model a health care system, based upon universal coverage, supported co-management of patients and their families. The place of death, level of social support available at home, and degree of palliative care involvement was documented in 121 consecutive deaths from 1999-2002. FINDINGS: Following a period of skill sharing and program development, only 8.3% of HF patients in the collaborative program required specialized palliative care intervention for complex symptom management, carer support, and issues related to spirituality. Twenty percent of this cohort died in nursing homes underscoring the importance of supporting our nursing colleagues in this setting. CONCLUSIONS: In spite of well-documented difficulties in determining prognosis, it is the St George experience that key principles of a palliative care strategy can be implemented in a HF disease management program with support and consultancy from expert palliative care services.

Original languageEnglish (US)
Pages (from-to)68-75
Number of pages8
JournalThe Journal of cardiovascular nursing
Issue number1
Publication statusPublished - Jan 2004
Externally publishedYes


ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine

Cite this

Integrated, collaborative palliative care in heart failure : the St. George Heart Failure Service experience 1999-2002. / Davidson, Patricia M; Paull, Glenn; Introna, Kate; Cockburn, Jill; Davis, Jan Maree; Rees, David; Gorman, David; Magann, Linda; Lafferty, Mary; Dracup, Kathleen.

In: The Journal of cardiovascular nursing, Vol. 19, No. 1, 01.2004, p. 68-75.

Research output: Contribution to journalArticle