Abstract
Objective: There is growing interest in the use of networks to facilitate knowledge exchange in health-care settings. The goal of the Dept. of Veterans Affairs (VA) Chronic Heart Failure (CHF) QUERI program is to improve the quality of care for heart failure (HF) patients and implement evidence-based practices (EBP) throughout the VA system. One strategy to achieve this goal was to create a VA Heart Failure Provider Network which occurred in 2006. We sought to conduct a formative evaluation of this well-established network to assess its perceived value by the members participating in it to improve HF care for Veterans. Method: Qualitative data was gathered using semi-structured phone interviews with selected HF Network members (n=25). All current members who had been participating in the HF Network for at least six months and hadn’t participated in the phone interview completed a web-based survey (n=878). The survey response rate was 24.9%. The HF Network members include leaders from Central Office, regional and facilities, chiefs of cardiology, physicians, nurses and others from all VA facilities (n=144). Results: Qualitative analysis of interviews showed that members participated in the HF Network to stay informed and maintain or enhance their knowledge in this area. Collaboration within and between VA facilities was frequently mentioned as a facilitator to achieve the goals of the HF Network. Also, many members mentioned that the web-based meetings and conference calls about HF clinics/programs were the most helpful because these methods provided access to new and practical ideas about solving problems and implementing changes in their own facility and to the members stay informed concerning heart failure care. Regarding barriers to greater involvement in HF Network activities, the most commonly noted barrier was lack of resources with members frequently mentioning lack of staff, time and local support. Quantitative findings strongly support the findings. Among the respondents (n=219), 90% of all members reported that the HF Network helped them establish collaborations and/or to network among members of the HF Network at least to a moderate extent. Interestingly, 63.8% of all members also reported that their participation in the HF Network provided them with names of contacts for networking and potential problem solving. 94.1% of the members found attending the web-based meetings and conference calls helpful in learning about barriers and facilitators in setting up or running HF program. Conclusions: Members perceived this social network of heart failure providers as a platform for the exchange of both explicit and tacit knowledge with the goal of improving quality of care for Veterans with heart failure. Implications for Policy or Practice: Social networks offer an effective platform for the implementation of EBP to improve the quality of HF care from local, regional to national levels.
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