Surrey-North Delta Division of Family Practice

Shared Care Project: Heart Failure

Project Completion Date: June 30, 2024

Project Contact: Alina Alesu


The Heart Failure project aims to increase collaboration and communication between SND Family Physicians, NPs, Cardiologists, and Outpatient Heart Function Clinic (HFC) leadership, ultimately improving heart failure patients’ health outcomes. 

The primary focus is to integrate SND Family Physicians into the HFC care pathway, thus improving the transition of care between HFC specialists and FPs. This will enable a smooth journey through the system by ensuring clear communication and robust engagement between providers.

Expected Outcomes of the project include:

  • Improved communication and coordination of care between FPs and Primary Care by including FPs in the HFC roadmap
  • Increased FPs' knowledge and confidence to better support patients with HF
  • Improved awareness of the HFC services and collegiality between FP and the outpatient HFC staff
  • Increased number of FPs aware of how to contact HFC to 50 % (vs 33% baseline)
  • Improved experience for patients with HF issues
  • Increased number of referrals from FPs to HFC post-intervention