A system redesign for American Heart Association certification standardized heart failure care coordination and established a replicable framework for improving hospice and palliative cardiac care.
A structured system redesign focusing on education, documentation, and care coordination can successfully guide hospice programs to achieve AHA Heart Failure Certification.
Heart failure patients often arrive at hospice with advanced symptoms, variable care plans, and limited coordination across settings. To address this, Samaritan Healthcare and Hospice pursued the American Heart Association Palliative/Hospice–Heart Failure Certification. The initiative required a full system redesign focused on standardizing education, documentation, care coordination, and performance measurements. This article outlines the challenges encountered, including low compliance rates and documentation barriers, and describes the process used to achieve certification in October 2025. Key strategies included forming an interprofessional Advanced Illness Management Committee, implementing new triage and clinical tools, launching performance improvement plans, and fostering a culture of collaborative learning. The resulting care model now serves as a framework for additional serious illness pathways and offers a replicable approach for hospice and palliative care programs seeking to strengthen cardiac care delivery.
Donna M. Fahey (2026) studied this question. A system redesign for American Heart Association certification standardized heart failure care coordination and established a replicable framework for improving hospice and palliative cardiac care.