Transforming Advanced Heart Failure Programs: Addressing Institutional and Systemic Drivers of Racial and Ethnic Disparities in Care

Institutional and systemic practices and policies contribute to lower-quality care and adverse outcomes among diverse racial and ethnic groups and individuals with limited economic resources. There are ample opportunities to change the trajectory of patients with heart failure (HF) across racial and ethnic groups. Multiple studies and quality improvement initiatives have demonstrated strategies to improve the care of diverse racial and ethnic populations living with HF, yet dissemination remains limited. This state-of-the-art review examines structural racism in the context of HF, outlines evidence-based strategies for HF programs to improve access to advanced HF therapies and reduce disparities in treatment outcomes, and discusses priorities for implementation and dissemination science efforts to address structural causes of disparities in HF care.