Abstract 248: IMPLEMENT-HF: An Initiative To Improve Guideline Adherence Across The Continuum

Abstract

Background & Objectives: Nearly 1 in 4 heart failure (HF) patients are readmitted within 30 days of discharge and nearly half readmitted in 6 months. HF prevalence is projected to continue increasing resulting in over 8 million adults with HF by 2030. Rising prevalence and poor outcomes provide significant improvement opportunities. Health system participation in a quality improvement (QI) initiative promoting adherence to evidence-based scientific clinical practice guidelines informs high quality care and improves patient outcomes. IMPLEMENT-HF, an American Heart Association (AHA) multi-site QI collaborative across inpatient and outpatient settings, uses implementation science and data analysis to improve guideline adherence across the HF care continuum. Methods: The IMPLEMENT-HF program targets the transformation of HF care in seven national regions. Organizations across the care continuum collect baseline and 30-day follow-up HF data and contribute to learning collaboratives. Data sources include HF measures in the AHA Outpatient Pilot Registry and Get With The Guidelines®-Heart Failure (GWTG-HF) inpatient and post-acute data. In addition to quantitative data, qualitative data including needs assessments, model sharing queries, and evaluation surveys are assessed. After establishing benchmark data, performance is evaluated continuously to identify care gaps. Opportunities for HF QI from this analysis emanate from 1:1 site meetings, regional, and initiative-wide learning collaboratives. AHA staff monitor data to recommend improvements, provide consultation, and deliver targeted training and resources to address common guideline adherence barriers. Intended Analyses: Demonstrate improved guideline adherence across the currently participating 60 sites; benchmark clinical outcomes, esp., mortality, against prevailing community norms with a goal absolute reduction in cardiovascular mortality of 5%; and use multi-site collaboration to develop and promulgate implementation strategies. Conclusions: This three-year multi-region QI initiative connects sites to share challenges and strategies, develop resources, and analyze data to foster continuous guideline adherence improvement across the HF care continuum.