Can Prov HFC Questionnaire, V1.1 April 18,2014
Can_Prov_HFC_ questionnaire, V1.1 April 18,2014
Welcome
As you know, Dr. Serge LePage and I are conducting a questionnaire that is designed to collect information about how heart failure care is offered to patients in your area or province. We are doing in order to determine the variation in access and care for patients with heart failure across Canada so we can present this at the upcoming 2014 Hear Failure Forum in Montreal May 30 and 31 this year. We hope to stimulate discussion on the current and future state of HF care. We hope you can take approximately 2 minutes of your time to complete this questionnaire and mail to .
Please note, you will not be identified individually unless you wish to (at the end) be. There is also a section at the end for your comments regarding this questionnaire (both good and bad). Thank you very much for your time.
Best Regards,
Jonathan Howlett, President, Canadian Heart Failure Society
Serge Lepage, President, Quebec Heart Failure Society
Select the answer that fits best for you:
- How many patients with HF do you see in an average work week (Mon-Fri)
□6-10
□10-20
□20-30
□>30
Please check ALL that apply
- Please describe your Perspective on heart failure care.
□I would like the family MD to take care of the ROUTINE/STABLE heart failure patients, especially if there is a care plan from us
□I try very hard to stabilize the HF patient and then send back to the family doctor for their HF care after that
□We try not to take patients in our HF clinic with so called diastolic HF
□We try not to take extremely elderly patients with HF if at all possible
Select the answer that fits best for you:
a)This question surrounds wait times for HF patients for HF clinics. How long does it take for your clinic to see a ROUTINE referral? / □Same or next day□Within 1 week
□Within 2 weeks
□Within 1 month
□Within 3 months
□Within 6 months
□We are not taking new patients right now
Select the answer that fits best for you:
b)How many Heart Failure patients in your area are currently being ACTIVELY followed in a HF clinic? / □<100□101-400
□401-1000
□1001- 3000
□3001-8000
□> 8000
□I have no idea
Select the answer that fits best for you:
c)What percent ofHeart Failure patients in your area are currently being ACTIVELY followed in a HF clinic? / □< 10%□10-19%
□20-29%
□30-50%
□> 50%
□I have no idea, but I think it is very low
□I really have NO IDEA!
Please check ALL that apply
d)Do you think it is reasonable to have HF clinics see patients with HF, provide a care plan, and then actively follow ONLY HIGH RISK or COMPLEX patients, sending the rest to primary care teams? / □No, just a bad idea□Yes, but only selectively as few primary practices can follow even simple patients
□Yes, we should develop capacity within primary care teams to do low risk disease management so that HF clinics can spend their time with high risk patients and assessments, advanced therapies
□Yes, I do not trust most family MDs to titrate drugs
□It depends upon the geographic area
Select the answer that fits best for you:
e)What percent of all patient visits (face to face) in your Heart Failure Clinic occur with a Doctor present? / □All of them□< 20%
□21- 40%
□41-60%
□>60%
□I do not know
Please check ALL that apply
f)What percent of eligible HF patients refuse either ICD or CRT therapy? / □< 10%□11-24%
□25-50%
□I usually get them AFTER the Device has been placed
□I leave this discussion to the EP colleague
□I have no idea
All answers will remain anonymous, and we appreciate your input!
Any comments for us?
Thank you again for your time!
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