About the Project
In her role compiling heart failure best practices at the provincial level, Dr. Liz Swiggum hears about current innovations happening in other regions. One of these is the creation of a Cardiogenic Shock (CS) team, a multidisciplinary team that provides rapid decision-making and care for patients with advanced heart failure and cariogenic shock. These patients have an exceptionally high mortality rate, with challenges in early recognition. In other institutions, both internationally and in Canada, implementing CS teams has resulted in significant improvements in patient mortality.
Prior to the development of the Cardiogenic Shock team in Victoria, it was individuals who would make a decision about the plan of care, rather than taking a team-based approach. Launching the CODE Shock team involved a wealth of interest holders beyond Dr. Swiggum, including Interventional Cardiologists (Dr. Nadra), Cardiac Anesthesiologists (Dr. Gregson), Cardiac Surgeons (Dr. Singal), Intensivists (Dr. MacDonald) and Emergency Room Physicians (Dr. Turner). Key supporters from Island Health included Marc-Andre Masse (Manager CCU/CVU), Jesse Bhondi (Director, Heart Health), Krista Mann (Manager CSS/Cath Lab), Carrie Homuth (Manager ICU), Aaron Renyard (Cardiovascular Clinical Nurse Educator), and Laura Shaw (Heart Health Quality Coordinator).
The first goal of the CODE shock team was the development of an algorithm to improve early identification, rapid decision making, and patient mortality for patients experiencing Cardiogenic Shock. Through working together on the algorithm and its implementation, there has been a notable increase in communication and engagement across all Cardiac units, ER and CERT team members. This has resulted in earlier multidisciplinary team discussions and engagement. Cardiovascular CNE Aaron Renyard reflected on the funding that brought people together for this important work, “Truly understanding the other areas that are impacted by this is crucial”.
Ongoing initiatives are focusing on building the REDCap database and reviewing cases, along with innovation and development of the first multidisciplinary fan outcall using technology and an app application through switchboard.