Examples of what has been done

Nurse-led outpatient clinics


Nurse-led heart failure clinics in Sweden provide coordinated disease management for HF patients. These clinics are led independently by specialised HF nurses, who provide rapid follow-up after hospitalisation and intensive patient education.

What they did

There are many such clinics in Sweden, but in one sample study1 HF patients received nurse-led care in a HF clinic and were followed up for 12 months. The first 1 hour follow-up visit was scheduled 2-3 weeks after discharge from hospital. Patients and their families received information about their condition and, if necessary, medication treatment was optimised. The HF nurse also provided psychosocial care over the phone. In case of a deterioration of the condition, patients were scheduled to visit the HF clinic for additional treatment.

What they achieved?

Reportedly, over two thirds of hospitals in Sweden are reported to have adopted the concept of a specialised HF clinic. 1

In one study, treatment in a nurse-led HF clinic has been demonstrated to reduce hospital admissions, mortality and days spent in hospital, and increased the self-care of HF patients. 1

Resources and other practical implications

Nurse led follow-up can significantly improve health outcomes for HF patients and is likely to be cost-effective.

Links, references, and key reading

  1. Strömberg A, Mårtensson J, Fridlund B, et al. Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure. European Heart Journal 2003;24(11):1014-23.