Emergency Department Management of Heart Failure and COPD: A National Survey of Attitudes and Practice

• Published in: Canadian journal of emergency medicine Vol. 18; no. 6; p. 429
• Main Authors: Hale, Michael K P, Stiell, Ian G, Clement, Catherine M
• Format: Journal Article
• Language: English
• Published: England 01-11-2016
• Subjects: Attitude of Health Personnel; Canada; Cross-Sectional Studies; Disease Progression; Emergency Medicine - organization & administration; Emergency Service, Hospital - utilization; Emergency Treatment; Female; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - therapy; Humans; Incidence; Male; Outcome Assessment (Health Care); Physicians - statistics & numerical data; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - therapy; Severity of Illness Index; Surveys and Questionnaires; Heart failure; Decision tool; Emergency medicine; COPD
• ISSN: 1481-8035
• DOI: 10.1017/cem.2016.24

The Ottawa Heart Failure Risk Scale (OHFRS) and the Ottawa COPD Risk Scale (OCRS) were developed in order to estimate medical risk and to help guide disposition decisions for patients presenting to the ED with acute exacerbations of heart failure (HF) and COPD. We sought to determine physician attitudes towards these two new risk scales and to identify potential barriers to their ED implementation.
Two self-administered online surveys were distributed to the Canadian Association of Emergency Physicians. The surveys each consisted of 16 questions relating to the OHFRS and OCRS. The primary outcome measures were the overall physician rating of the two risk scales. Secondary outcome measures assessed the likelihood of risk scale implementation into Canadian EDs, as well as the perceived barriers to such implementation. Descriptive statistics were used.
For the OHFRS survey, we received responses from 195 emergency physicians (35.7%). Overall, 74.4% approved of the risk scale based on a Likert rating of 4 or 5 and 66.7% believed that the risk scale would be implemented at their hospital. For the OCRS survey, we received responses from 208 emergency physicians (38.1%). Overall, 76.9% approved of the risk scale based on a Likert rating of 4 or 5 and 70.2% believed that the risk scale would be implemented at their hospital.
Canadian emergency physicians are very supportive of the new OHFRS and OCRS. We believe these risk scales will assist physicians with making safe and efficient disposition decisions and improve outcomes for patients suffering from HF and COPD.