Improved care path way for patients with heart failure

The Heartfailure Day Care Clinic, gets high grades from heart failure patients and their families. Care has become more accessible for the patients and the number of care days have been reduced.

Each year, about 6,000 people in Sweden are diagnosed with heart failure, and this number will rise as we live longer. In Stockholm alone, 40,000 patients have heart failure as do 250,000 throughout Sweden. Despite considerable healthcare resources, new drugs and increased knowledge about heart failure, the survival rate has not improved over the past decade.

This was the starting point for creating a patient-centered, value-based and more effective heart failure care service. The first step was to inventory the patient's path through the care system. This showed that far too few patients were referred to the heart failure clinic where they could receive evidence-based treatment.

Patients needed a reassuring access

Living with heart failure is difficult. Many patients experience anxiety. This is one reason why many patients soon return to the hospital following discharge, which has been known for some time. When the Center for Innovation took a closer look at this, it turned out that the problem was even greater than previously thought. An impressive 59% of patients discharged from the emergency department soon reappeared. Many came back within 3–6 days, and sometimes after just a few hours. The reason was that they had not received the care they needed.

For patients and their families, accessibility and feeling safe were the most important factors, according to the patient survey completed at the start of the project. They wanted to know where they could turn instead of going to the emergency department.

Decrease re-admission rates

Since the Heartfailure Day Care Clinic opened in March 2015, both emergency visits and readmissions have sharply declined – to less than 10% for the Heartfailure Day Care Clinic patients. The patients feel they now have access to better health care. Being able to call the ward directly and talk to a nurse or doctor with specialist training make patients feel safer. The ward also supports other healthcare providers outside the hospital that needs advice.

"I feel safe because I can live a normal life. I can visit Södertälje and go and swim in the indoor pool. And soon, I'm going to visit Öland for a bird-watching trip. Something I would not have dared otherwise", says Ingrid Danielsson, patient at the new Heartfailure Day Care Clinic.

The new model means that the patients are more satisfied, while costs declined sharply. The explanation is that the entire care pathway has become more efficient, patients receive care at the right time - from the correct healthcare staff.

Fewer emergency department visits was reported.
1,200 patient care days were released.

Offering more outpatient visits has reduced the burden on inpatient care. One could say that healthcare has saved resources by giving patients more of what they need, above all through being more accessible.

Strengthening the network around the patient


The Heartfailure Day Care Clinic serves as a bridge between outpatient and inpatient services and provide safe and accessible care, regardless of where the patient may be in the care path way. Communication within the network has become faster and more direct, both within the hospital and among other healthcare providers whom patients meets.

The Heartfailure Day Care Clinic collaborates with about ten Advanced Home Care Units (Swedish ASIH). Telemedicine rounds strengthen the network around the patient, and thereby transmit the patient safely.

In addition, the Heartfailure Day Care Clinic attracts experienced personnel. Many nurses applied for the new positions wishing to be involved in developing this new way of working and improve care to these patients.

The next step is to disseminate this model to reach more heart failure patients as well as other diagnostic groups.


Nina Lahti
Phone: +46 (0)70 085 69 76
E-mail: Nina Lahti

Improved care for heart failure

The Heartfailure Day Care Clinic is part of the improved care path way for patients with heart failure. It opened in March 2015 and was jointly developed with the Department of Cardiology.

Project coordinators at the Center for Innovation: Helén Skogsberg, the Heartfailure Day Care Clinic, and Nina Lahti, Optimized care path way for patients with heart failure.

The Heartfailure Day Care Clinic for patients with heart failure was awared with the "Golden Apple" by the Stockholm County County Council and have received Mona Schlyter's clinical prize. The Heartfailure Day Care Clinic model has now been copied to more diagnostic areas at Karolinska University Hospital and by several other hospitals.

About the Center for Innovation