Stoplight Tools for CHF and COPD
Stoplight Tools for Congestive Heart Failure (CHF) and/or with Chronic Obstructive Pulmonary Disease (COPD) have adapted helpful recommendations for patients with these conditions based on a literature review of innovative self-management stoplight tool templates, evidence-based informed best practices, and expert opinion. The Tools are in an easy to review one-page format to help patients gauge when they are doing well with their condition (green zone), when the need to exercise caution (yellow zone), and when they need to seek immediate emergency attention (red zone).
These tools have been in use by Rapid Response Nurses of the Toronto Central Local Health Integration Network since inception of the program. Rapid Response Nurses make visits to clients that have recently been discharged from hospital for CHF or COPD and conduct an in home head-to-toe assessment, medication reconciliation, and reinforce teaching on their chronic conditions using the Stoplight Tool. These tools are in plain language derived from Plan-Do-Study-Act (PDSA) cycles with Rapid Response Nurses and "Teach Back" methodology and have ensured there are no contradictions between the COPD recommendations and the CHF recommendations.
In 2019 the English versions of the Stoplight Tools for CHF and COPD were translated into 12 languages that many TCLHIN clients speak as their mother-tongue or sole language. These include French, Italian, Portuguese, Spanish, Chinese (simplified and traditional text), Arabic, Persian, Greek, Hungarian, Polish and
Urdu. All 12 versions are available below:
 CHF Stoplight Tool Adapted from The Agency for Healthcare Research and Quality Red-Yellow-Green Congestive Heart Failure (CHF) Tool, 2007 (https://innovations.ahrq.gov/qualitytools/red-yellow-green-congestive-heart-failure-chf-tool) and Nielsen GA, Bartely A, Coleman E, Resar R, Rutherford P, Souw D, Taylor J. Transforming Care at the Bedside How-to Guide: Creating an Ideal Transition Home for Patients with Heart Failure. Cambridge, MA: Institute for Healthcare Improvement, 2008 (www.ihi.org).
 COPD Stoplight Tool Adapted from The Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease GOLD Executive Summary, 2013 updated 2017 (https://www.ncbi.nlm.nih.gov/pubmed/22878278); The American Lung Association, 2015 (https://www.lung.org/assets/documents/copd/copd-action-plan.pdf) and template from and The Institute for Healthcare Improvement Stoplight (Red-Yellow-Green) Tools for Patients with Asthma or Diabetes (ND) (http://www.ihi.org/resources/Pages/Tools/StoplightRedYellowGreenToolsAsthmaDiabetes.aspx).
There are a number of resources and supports available to primary care providers and their patients with CHF or COPD. In Toronto the following are suggested for possible consideration:
Telehomecare for CHF and COPD is a program that supports patients with these conditions through health coaching and remote monitoring. It complements the care provided by the patient's primary care provider. Patients are educated on their condition and provided easy-to-use equipment (on loan) to measure their vital signs and answer simple questions about how they are feeling. Specially-trained registered nurses – or other clinicians – monitor results and alert the primary care provider if there are signs of an exacerbation. Weekly telephone coaching educates patients about how their behaviour affects the way they feel. Primary care providers receive regular reports on a schedule they prefer.
Please click here to enroll patients into the Toronto Central LHIN Telehomecare program. There is no cost to patients or providers and patients report a high degree of satisfaction and a decreased need to go to the Emergency Department.
Telemedicine IMPACT Plus (TIP) is a service that provides rapid access to a team of professionals to enable proactive health and social care for patients with complex conditions, and their family caregivers. Telemedicine IMPACT Plus is an OHIP-Billable Service that supports coordinated care planning and derives new solutions for addressing the patient's chronic conditions.
The Primary Care Provider, patient, and their family caregivers benefit from the support of a dedicated nurse who coordinates the patient's circle of care. The TIP consultation clinic empowers the patient and their caregivers to manage complex health conditions.
TIP consulting teams have a core membership (as required) of a: Psychiatrist, Internist, Pharmacist, Dietitian, Social Worker, and a Home and Community Care Coordinator.
Some of the TIP teams offer specialty consults in: Geriatric Medicine, Geriatric Psychiatry, Diabetes, Endocrinology, Pain Management and Intellectual and Developmental Disabilities.
For more information please contact the Mid-West Toronto Sub-Region Team by email: TIPteam@uhn.ca or by phone at 416-603-5800 X 4015.
To make a referral to TIP please download and complete the following referral form.
West Park's Inpatient Respiratory Rehabilitation Service is designed to help patients with chronic lung impairment improve or increase their ability to live independently in the community. This in-patient rehabilitation service provides education, planning and coping skills, and a supervised exercise program that includes breathing control techniques.
In-patient respiratory rehabilitation is available for people unable to take advantage of West Park's out-patient Respiratory Day Hospital.
To make a referral to the West Park Inpatient Respiratory Rehabilitation Service please download and complete the following referral form.