Heart failure is a complex, progressive life-limiting condition affecting 6 million Americans. By 2030, it is projected to affect 8 million people (3% of our population), consuming $69.8 billion in direct medical cost.1,2  With a 5-year mortality of 43%,2,3  many patients with heart failure experience poor quality of life (QOL) and endure signs and symptoms such as dyspnea, pain, gastrointestinal disorders, thirst, and anxiety. As the stage of illness advances, so do intensive care unit (ICU) admissions, especially at the end of life. These admissions account for 20% of US deaths and consume approximately 20% of hospital expenses.4  As a result, hospitals are reducing the numbers of acute care beds and increasing the numbers of ICU beds to accommodate current and projected increases in ICU admissions.5 

Mortality associated with heart failure increases with each hospitalization. Rising costs and system strain have prompted...

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