Changes in heart failure outcomes after a province-wide change in health service provision a natural experiment in Alberta, Canada.

Background: The Alberta Cardiac Access (ACA) initiative was implemented in the spring of 2008 to increase access to specialized heart failure (HF) clinics after hospital discharge.

Methods And Results: We identified all adults hospitalized with a most responsible diagnosis of HF between April 1999 and December 2009. We randomly selected 1 episode of care per patient and evaluated outcomes using interrupted time series: the a priori specified primary outcome was all-cause readmission or death in the first 30 days postdischarge.

The Alberta Cardiac Access Collaborative: improving the cardiac patient journey.

The Alberta Cardiac Access Collaborative (ACAC) is a joint initiative of Alberta's health system to improve access to adult cardiac services across the patient journey. ACAC has created new care delivery models and implemented best practices across Alberta in four streams across the continuum: heart attack, patient navigation, heart failure and arrhythmia. Emergency medical providers, nurses, primary care physicians, hospitals, cardiac specialists and clinicians are all working together to integrate services, bridge jurisdictions and geography with one aim--improving the patient journey for adults in need of cardiac care.