Barriers to the management of Heart Failure in Ontario Long-Term Care Homes: an Interprofessional Care perspective

Abstract

Background: With population aging, the prevalence of heart failure (HF) is risingin long-term care (LTC) homes. Given this burden, there is an urgent need to establish effective HF management programs.

Methods and Findings: To understand what barriers would need to be addressed to develop such a program, we conducted a series of consultations among various LTC staff, as well as residents and their family caregivers. This article uses data obtained from the consultations to describe the interprofessional (IP) barriers that exist among the various LTC staff roles. Consultation methods included a Delphi survey followed by focus group interviews of LTC staff, and then personal interviews with LTC residents with HF and their family caregivers. Data were interpreted using an IP care framework in which interpersonal relationships among LTC staff provide the most direct influence on collaborative resident-centred practice, within the broader context of conditions within the LTC home, which in turn are housed in the broader context of systemic determinants.

Conclusion: Across all data sets, the most consistently mentioned determinant was communication between the resident and the healthcare team, between different healthcare providers, between shifts, between medical specialists, and between the long-term care home and the hospital.