A Heart Failure Collaborative to Accelerate Improved Patient Outcomes in 3 Metro Markets

Abstract

Background Nearly 6.5 million Americans are living with heart failure (HF), the leading cause of hospitalization among adults aged 65 and older. Despite advancements in medical therapy, HF patient outcomes remain of concern. HF readmission rates remain high and only half of patients diagnosed with heart failure are expected to live beyond 5 years of diagnosis. Increasing prevalence and poor outcomes provide significant opportunities for improvement. Hospital participation in a quality initiative designed to improve care by promoting adherence to the scientific guidelines, such as Get With the Guidelines®-Heart Failure (GWTG-HF), assists hospitals in effectively delivering high quality care to improve patient outcomes. The objective of this project is to form multidisciplinary collaboratives that will rapidly implement evidence-based guidelines to develop best practices that can be shared to improve heart failure patient outcomes. Methods The AHA will lead a quality improvement initiative for transforming heart failure care in three major cities including Chicago, Milwaukee and St. Louis. • A retrospective review was conducted using GWTG-HF on measures with low adherence from participating hospitals in the metro markets. • Baseline data of specific HF measures from Quarter 1, 2018 were analyzed and to determine areas of improvement needed. • Using regional and 1:1 hospital meetings, AHA will lead a quality improvement initiative to transform HF patient care. • The HF project will focus on professional education, enhancing systems of care and facilitating the sharing of best practices. • The patient population will include patients from GWTG-HF with a principal/primary diagnosis of heart failure. Results The project goal within the 2-year timeframe of this initiative is to achieve 20% improvement from baseline data OR achieve AHA's 85% adherence threshold in each measure. AHA Quality staff will observe and monitor market-level data within GWTG-HF to uncover and recommend improvements, provide consultation to clinicians, deliver targeted training and resources such as webinars, conferences, toolkits, care pathways, educational materials and to foster best-practice sharing to address common barriers. Limitations Participating hospitals vary in size, discharge volume, GWTG participation tenure, FTE support and resources • *There is incomplete baseline date for the three thirty day follow up measures • Initiative implementation may vary slightly in 3 metro markets Conclusions The two-year multi-city quality initiative will bring together multiple hospitals to share best practices, develop resources and analyze Get With The Guidelines data for performance improvement to accelerate heart failure patient outcomes. Further investigation is merited evaluating the effectiveness of quality collaboratives to enhance care.