Palliative care in end-stage heart failure: experience of a collaborative approach in a secondary care setting.

Heart failure remains an ultimately fatal condition that causes significant symptoms as it progresses. The involvement by palliative services in this patient group has been suboptimal despite many years of guidance from international cardiac societies who recommend a palliative focus for these patients. At Hutt hospital, we have implemented a cardiology supportive care clinic in an attempt to improve the care of our advanced heart failure patients. Our initial experience is that the clinic has resulted in improvements in communication with patients and their families. Management plans and goals of care have been clearly documented, and there has been clarification of roles between the key stakeholders who manage end-stage heart failure patients. A formal integrated palliative approach has been helpful for our end-stage heart failure patients and there is potential for this concept to be beneficial for other end-stage medical conditions.