Evaluation of new Peer Mentorship Program will help support heart transplant patients beyond the clinic

A new study will evaluate the implementation of a peer mentorship program (PMP) to improve patients’ experience of the journey of care to and after heart transplant. The program will connect patients with heart transplants or mechanical heart pumps with new patients to provide support and mentorship.

This project, led by Wynne Chiu, a Clinical Nurse Specialist with the Heart Failure and Transplant Team at St. Paul’s Hospital, has received funding through the 2024 Vancouver Coastal Health Research Institute (VCHRI) Team Grant Awards, as well as the Transplant Foundation of BC (TRF). The VCHRI Team Grant Awards support projects that contribute to the improvement of health care delivery and address pressing challenges in health care. 

This project is a continuation of work that Chiu and her team began as a pilot through the Providence Health Care (PHC) Practice-based Research Challenge. 

Providing support beyond the clinic

While heart transplants and mechanical heart pumps are life-saving treatments that improve patients’ health outcomes, the process of consultations, diagnostic testing, medication adjustments, screening and decision-making can cause uncertainty and distress in patients and families.

With a peer mentorship program, patients with similar conditions and experiences are matched to provide guidance and support for each other. Chiu and her colleagues with the Heart Failure and Transplant Team had heard from patients for years about the need for this type of program, which can provide mentorship and resources for patients that go beyond the clinic. 

“There’s so much more to living with a heart transplant or a ventricular assist device, also known as a heart pump or VAD, that you can only get from people who have experienced it and walked in those shoes,” says Chiu. 

While clinicians can answer patients’ questions about medical status, and nurses and psychologists on the clinical team provide support, PMPs provide a community that clinicians can’t.

“It’s so scary, to go through something that is life-changing for these patients. Having someone who is like you, at least in the fact that you both have heart failure, makes you feel less isolated,” says Chiu.

Without a formal program, patients still find ways to meet with each other, and health care workers sometimes informally facilitate these connections. Chiu and her team knew that patients could benefit from a more formal program, but they lacked the resources to get it going. This brought them to the PHC Practice-based Research Challenge. 

Pilot project funded through Research Challenge provided groundwork for current study

The PHC Practice-based Research Challenge is an annual competition that offers nurses and other health care professionals the opportunity to work with a mentor and learn to design and implement a research project. The team was mentored by Chiu and led by heart transplant clinic nurse and patient educator Josie Mackey. Their pilot project, which also received funding from the TRF, studied patient perspectives on a PMP and gathered information on what the structure, process and content of the program should look like. 

The team collaborated with ten patient partners for a series of guided interviews. They collected foundational evidence on how the program should be implemented, including what factors create a good peer match, feedback on how to facilitate impactful partnerships, and processes to conclude the mentorship experience in an appropriate way.

“With this information, we now want to actually implement the program. That’s why we pursued the VCHRI grant, because now this is something bigger. We want to make this program a permanent service we can offer to patients, and we want to do it right, so that it can be sustained,” says Chiu. 

Implementation of the project funded through VCHRI Team Grant

The VCHRI Team Grant gives Chiu and her team the opportunity to translate the innovative knowledge gained from the pilot program into practice, and to measure the impact of the program on outcomes that matter most to patients and families. 

Before the new PMP is implemented, Chiu and her team will be conducting focus groups with both patients and clinicians to gather more feedback on potential barriers the program may face and strategies to help it succeed. When the program begins, the team will collect information from the mentors and mentees and evaluate the process as they move forward. When the study is complete, the team will have evidence on the best roadmap to successfully and sustainably implementing a PMP as a standard of care. 

Study made possible through the collaboration of patient partners

Chiu and her research team were honoured to receive the VCHRI Team Grant Award and are excited by the opportunity to pursue this project. Chiu is pleased to partner with co-principal investigator Dr. Sandra Lauck, who holds the St. Paul’s Professorship in Cardiovascular Nursing at UBC and is a UBC Knowledge Exchange & Mobilization Scholar. She gives credit to all of the patient partners who supported the pilot program, many of whom will also be involved in the new study, including Kristi Coldwell, Naomi Lee, Jillianne Code and Mark Bains. The pilot study was successful due to their contributions, and the research team is hoping for the same level of engagement for the upcoming study.

“As a patient partner and heart transplant recipient, I know firsthand the profound impact that peer mentorship can have on heart transplant patients,” says Bains. “The peer mentorship program bridges the gap between clinical support and the day-to-day realities of living with a heart transplant or artificial heart.”

Once this peer mentorship program is in place and sustained, it will be a complement to what the Heart Failure and Transplant Team does for patients.

“It’s funny, a lot of people’s feedback is ‘I can’t believe this isn’t already in place,’” says Chiu.