Chronic heart failure

Clinical priorities and organisational models

Health services and clinicians can use these models, guidelines and resources to improve care delivery and quality of life for people with chronic heart failure.

Chronic heart failure is a complex condition with exacerbating features caused by structural or functional abnormalities of the heart. It is a severe, disabling condition with multiple comorbidities which negatively impact on quality of life.

The incidence of chronic heart failure increases with age, and it is a common comorbidity with conditions such as atrial fibrillation, diabetes and renal disease. Prevalence remains high and it is one of the leading causes of admission and readmission to hospital in NSW.

Evidence-based management involves the multidisciplinary coordination of care across acute and primary care providers to support self-management and reduce unwarranted clinical variation.

These resources were originally developed as one of the 13 clinical initiatives of Leading Better Value Care, a program accelerating value-based healthcare in NSW. They aim to:

reduce unwarranted clinical variation
support patients to self-manage their condition by tailoring education and resources to meet their needs
facilitate optimal care across the continuum and between settings, particularly after discharge and at the end of life.

Best practice principles include:

adherence with optimal pharmacotherapy
non-pharmacological interventions
community heart failure management programs
implantation of devices
surgical procedures
supportive end of life care.

Model of care

3Ci model of care 2023

Published: March 2023. Next review: 2028.

Organisational model of care to improve outcomes and reduce unnecessary hospitalisations for people with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) in NSW.

Download model of care (PDF 2.2 MB)

Guideline

iCARDIO Alliance Global Implementation Guidelines

Clinical guidelines for the management of heart failure, produced by the National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand.

View guidelines