The Spoke-Hub-Node Model of Heart Failure Care


The Integrating Heart Failure Care Initiative (IHFCI) was based upon the Spoke-Hub-Node model of integrated heart failure (HF) care. As providers and teams work with one another on implementing an integrated approach to HF care, it is important to have a common understanding of the Spoke-Hub-Node model, and what is required of each level of HF care provision (i.e. spoke, hub and node). This section contains the Spoke-Hub-Node model standards (CorHealth, 2017), a 1-page diagram of the Spoke-Hub-Node model, and a current state self-assessment tool for spokes and hubs.


  • Minimal Requirements and Key Clinical Services for Heart Failure Programs within a Spoke-Hub-Node Model of Care
    This document, released by CorHealth Ontario in 2017, is an evidence-based strategy to patient-centred HF management that is rooted in highly integrated and connected care teams across the entire care continuum (e.g. primary care, specialty services, and community-based teams of health care professionals). It lays out the requirements for spoke, hub, and node levels of HF care provision.
  • Click here for a diagram of the Spoke-Hub-Node Model of HF Care
    Patients with HF may require care from different settings within the spoke-hub-node network throughout their illness trajectory. Navigation through the network is facilitated by well-established referral criteria, bidirectional communication links, and collaboration between health care providers as guided by individual patient need and preference.
  • Current State Assessment of Heart Failure Care for Spokes and Hubs
    As you begin to identify other teams across your region who are interested in collaborating on an integrated Spoke-Hub-Node model for heart failure, this current state assessment tool can help you identify the spokes, hub(s) and the node, within your model, and assess their current capacity in heart failure care against the standards. The appropriate assessment can be circulated to providers/teams to complete and send back to you/the project lead.
  • Sample Meeting Activity – Defining the ‘Hub’
    This is an example of an activity that the Guelph Early Adopter Team used during a meeting aimed at defining the ‘hub’ for their region. The structure of their activity is a good example of how to frame the discussion around spoke/hub/node level care and the Quality Standard.