A mixed-methods landscape assessment of supportive care for heart failure

<b>Aim: </b>Understanding factors that shape leading health systems’ (LHS) perspectives around heart failure (HF) treatment. <b>Patients &amp; methods: </b>First of its kind study using a cross-sectional, descriptive, mixed method design (from executives and frontline healthcare providers) with quantitative survey (n <b>= </b>35) and qualitative interview (n <b>= </b>12) data from 47 participants (41 different LHS). <b>Results: </b>97% of LHS had dedicated HF programs, but variations in maturity highlights opportunities for care standardization. Treatment innovations continue, though practitioners may struggle to keep pace amid provider<b>/</b>patient barriers. HF programs strive to co-locate supportive care services to optimize treatment, but access can prove challenging. <b>Conclusion: </b>Opportunities exist, with external partner support, for LHS to become more comprehensive HF care providers, increasing standardization of care across LHS and improved HF treatment.<b>Plain language summary:</b><b> </b><b>What is this summary about?: </b>We interviewed frontline healthcare workers (such as doctors and nurses) as well as executives at large US health systems to understand how they treat people with heart failure. <b>What were the results?: </b>We learned that healthcare workers as well as executives would like to provide many different services to help people with heart failure. However, many health systems do not have all of these services available and can only provide a few basic services. We also learned healthcare workers sometimes struggle to keep up to date with new scientific discoveries and heart failure treatments. <b>What do the results mean?: </b>With support from external healthcare partners, health systems can improve their ability to treat people with heart failure.

**研究目的：** 旨在探究影响领先医疗系统（Leading Health Systems，LHS）对心力衰竭（heart failure，HF）治疗看法的相关因素。
**研究对象与方法：** 本研究为同类首创，采用横断面描述性混合研究设计，从LHS管理层与一线医护人员处收集数据：共纳入47名参与者，来自41家不同的LHS，其中定量调查样本量为35，定性访谈样本量为12。
**研究结果：** 97%的LHS设有专属HF诊疗项目，但各项目成熟度存在差异，这为诊疗标准化提供了优化空间。尽管HF相关治疗创新仍在持续推进，但临床从业者在应对医护方与患者层面的阻碍时，往往难以跟上创新步伐。HF诊疗项目致力于整合配套支持性医疗服务以优化治疗效果，但服务可及性常面临挑战。
**研究结论：** 在外部合作伙伴的支持下，LHS有机会发展为更全面的HF诊疗服务提供者，从而提升跨LHS的诊疗标准化水平，并改善HF治疗效果。
**通俗总结：**
**本总结旨在说明：** 我们访谈了美国大型医疗系统的一线医护人员（如医生与护士）及管理层，以了解他们针对HF患者的诊疗方式。
**研究结果如何？：** 我们发现，医护人员与管理层均希望为HF患者提供多样化的支持服务，但多数医疗系统无法覆盖全部服务项目，仅能提供少数基础服务。此外，医护人员有时难以跟进最新的科研进展与HF治疗方案。
**该结果有何意义？：** 借助外部医疗合作伙伴的支持，医疗系统可提升其HF患者诊疗能力。