🎯Three Phases · One Force Field
Every square belongs to one of three phases of mastery. Inside each square's detail panel, the four sections — Concepts · Skills · Actions · Plan — are the building blocks of these phases. Read each square with that ladder in mind.
📘 Learn It Tier 1 · Aware
Identity earned: Self-Advocate. The "know" — head knowledge, definitions, mental model of SCD and its red flags.
🛠 Live It Tier 2 · Active
Identity earned: Care-Team Member. The "do" — daily skills you can demonstrate and this-week actions that turn skills into habits.
📣 Share It Tier 3 · Certified
Identity earned: Ambassador. The "carry forward" — long-arc plan, teaching, mentoring, sharing insights with clinicians, advocacy.
🛡️Your Force Field — 16 Squares
Click any square to open its detail panel. Each square is a tile in your shield. Keep clicking, learning, and acting — your Force Field gets stronger every step.
What Is Heart Failure?
The heart can't pump or fill efficiently → fluid backs up, organs starve. ~6.7M U.S. adults. The #1 most expensive Medicare readmission pattern — and the most preventable with daily self-management.
PrimerHFrEF vs HFpEF
Two Faces of HF
HFrEF = ejection fraction ≤40% (weak pump). HFpEF = EF ≥50% (stiff fill). HFmrEF = 41–49%. Different first-line meds; same daily self-management.
AnatomyWho Gets It?
Risk rises with age, prior MI, uncontrolled HTN, T2D, CKD, A-fib, OSA, valve disease, family history. Most HF develops on top of years of unmanaged cardiovascular risk.
PrimerThe Numbers
~6.7M U.S. adults. ~25% 30-day readmission rate — most expensive Medicare condition. Median survival improves dramatically with the four pillars + daily weight + cardiac rehab.
PrimerDaily Weight — The Cornerstone
Same time, same scale, after voiding, before breakfast. Track daily. Catches fluid retention 24–72 hours before you feel short of breath. The single highest-leverage HF self-management habit.
Learn ItMaster the Four Pillars (HFrEF)
ARNi (or ACE/ARB) + beta-blocker + MRA (spironolactone) + SGLT2 inhibitor. Each pillar adds independent mortality benefit. All four together > any one alone — guideline-directed medical therapy.
Learn ItThe 3-and-5 Rule
Weight gain >3 lb in 2 days OR >5 lb in 7 days = call your team SAME DAY. Catches decompensation early, usually a diuretic adjustment. Skipping this is the #1 path to readmission.
Learn ItSodium <2 g/day · Fluid Limit
Sodium <2 g/day (most-missed lever). Restaurant meals = 1500–3000 mg. Read labels. Fluid often capped ~2 L/day per team. Dry mouth ≠ dehydration in HF — check before drinking more.
Learn ItHF Action Plan — Every Visit
Yellow zone (3-and-5, increased SOB, new orthopnea, swelling) → extra diuretic per plan + call team. Red zone (severe SOB at rest, pink frothy sputum, lightheaded, chest pain) → 911. Bring your weight log to every visit.
Live ItCardiac Rehab — Underused
36 supervised exercise + education sessions. Medicare-covered. Dramatically reduces readmissions, improves quality of life and survival. The most-underutilized HF intervention. Ask for a referral.
Live ItRemote Monitoring & Tech
Bluetooth scale → MyChart, weight + symptom apps, HF-clinic RN navigator review between visits. CardioMEMS implanted PA-pressure monitor for select advanced HF. Most check-ins can be virtual.
TechCare Team & Comorbidities
PCP + cardiologist + HF specialist + HF-clinic RN navigator + pharmacist + RD + cardiac rehab + behavioral health. Treat the cluster: A-fib (50%+), T2D, CKD, OSA, iron deficiency, depression.
Live ItFamily Catches Signs First
HF patients often miss their own early decompensation. A trained family member who weighs you in + watches for SOB / new pillows at night / leg swelling is pivotal. Share the 3-and-5 rule.
Share ItTeach, Mentor, Ambassador
Teach your family the four pillars + daily weight + the 3-and-5 rule. Mentor a newly-diagnosed neighbor through their first 90 days. Speak at cardiac-rehab graduations.
Share ItAdvance Care Planning
HF prognosis is variable but real. Have the goals-of-care conversation early — what matters to you, what you don't want, who decides if you can't. Document in advance directives.
Share ItJoin the ROI Study
PHIT — Population Health Impact Tracking. Aggregate & anonymous. Help prove this program reduces HF readmissions, ED visits, and total cost of care for Banner's HF population.
Study🩺 Hand-off to my Clinician
Print and bring to your next visit. This page tells your care team what you have prepared for, what you want to focus on, and how you would like to participate as an active member of the team.
- I am a Prepared Patient in training for Heart Failure. I have reviewed all 16 squares of this Force Field Fact Sheet.
- I have started building my Health Passport, my Red Flag list, and my 2-week home BP log to bring to every visit.
- I want to teach back what I have learned and have you correct anything I have misunderstood — especially around my BP goal, my med plan, and when to call vs. when to go to the ED.
What helps my visit
Two minutes for me to teach back. One question I prepared. My home BP log on my phone. Confirm my goal BP on the chart.
What I am working on
Hitting my BP goal · medication adherence · DASH-style eating · home cuff technique · sleep / sleep apnea screen · stroke-risk awareness (especially if I also have SCD or diabetes).
How I want to participate
Shared decisions. Full med list before changes. Tell me your top 1–2 priorities so we agree. Use the AHRQ SHARE Approach. Help me see my numbers, not just my prescription.
🔬 Help Prove This Works — Join the FFH ROI & PHIT Study
The Prepared Patient program is being studied to see whether better preparation actually reduces ER visits, hospital stays, and total cost of care — for you and for the people in your circle of influence. Your participation is voluntary, your data is aggregated and anonymized, and you can withdraw at any time.
➕ Add-On Force Field Card · Device or Skill Mastery
If your care plan adds a medical device or new skill, bolt on a 5-step Add-On Card. For HF common bolt-ons include: daily home weight scale (Bluetooth → MyChart), sodium label-reading + cooking, fluid-intake tracking, cardiac rehab (36 sessions), CPAP onboarding (if sleep apnea), implanted PA-pressure monitor (CardioMEMS for advanced HF), weekly med review.
Introduce
What it is, why it matters, what it does
Coach
Watch a demo + walk-through
Practice
Do it with a coach watching
Train
Use it daily with a check-in
Test
Demonstrate competence + earn badge
Ready to go deeper?
The Prepared Patient · Heart Failure course turns this fact sheet into a guided journey: pre/post knowledge checks, teach-back, daily-weight technique, four-pillar adherence training, badge tests, and your printable Health Passport. Earn Aware → Active → Certified.