Heart failure (HF) is a significant healthcare issue in Ontario with associated poor patient outcomes and
high cost to the healthcare system. In Canada, 600,000 patients are affected, and with the aging population
that number is expected to increase (Heart and Stroke, 2019). Nearly a quarter (23%) of individuals older
than age 85 have heart failure, and despite advancements in HF management, such as new medications and
devices, the mortality rate at five years is at a staggering 50% (Huitema et al., 2019).
HF is a chronic, complex condition and patients require care from multiple providers across the health care
system. Managing and supporting patients with HF along the care continuum and across transitions in care,
requires a coordinated approach that connects teams of providers to provide ‘wrap around’ care to patients.
To help improve care for patients living with HF and their caregivers in Ontario, CorHealth Ontario, in
partnership with Health Quality Ontario (HQO), is championing and continues to support the Integrating Heart
Failure Care Initiative (IHFCI). This initiative is grounded in two new sets of standards, including
CorHealth’s Minimal Requirements and Key Clinical Services for Heart Failure
Programs within a
Spoke-Hub-Node Model of Care and HQO’s Heart Failure Care in the Community for Adults Quality
which was recently released on February 27.
The output of IHFCI is a roadmap and toolkit that has been informed by the experience of local
implementation teams from three early adopter teams in Ontario and a provincial task group of administrators
chaired by Mr. Ted Alexander, Vice-President of Partnerships and Clinical Innovation at the eHealth Centre
of Excellence, and Ms. Debbie Korzeniowski, Executive Director of Prince Edward Family Health Team, health
care providers and patients. The roadmap provides concrete recommendations around how to go about building a
health team to improve HF care locally, and the toolkit provides tangible resources to get started.
For providers and administrators who identify with the undeniable need to transform how we care for patients
with HF, the roadmap and toolkit will help them navigate becoming connected, and improve outcomes for HF
patients and their caregivers. Over time, and with a sustained and coordinated effort, we can begin to raise
the bar for HF care in Ontario. The roadmap will become available in spring 2019.
Heart and Stroke Foundation (2019). Heart Failure. Retrieved from:
Huitema, A A, Harkness K, Heckman G, & McKelvie R S. (2018). The Spoke-Hub-Node Model of Integrated Heart Failure Care. Canadian Journal of Cardiology, 34, 863-870.