Abstract P247: Facilitation of the VA Hospital-to-Home Initiative to Reduce Readmissions for Heart Failure Patients: CHF QUERI

Abstract

Objectives: Reducing readmission rates for heart failure (HF) patients is the primary goal of the Department of Veteran Affairs (VA) and its’ Chronic Heart Failure (CHF) QUERI. It is also the goal of Hospital to Home (H2H) national quality improvement (QI) initiative cosponsored by ACC and the IHI. In January 2010 the CHF QUERI through its HF Provider Network (625 providers/members from 150 VA facilities) launched the “VA H2H” QI initiative by facilitating the implementation of the national H2H initiative at the VA facilities with focus on H2H’s 3 key areas. Methods: A total of 122 VA facilities were identified with >100 discharges during 2007-2008. Randomly, half of these facilities were assigned to the intervention group (n=61) and the remaining to the control group (n=61). From Month 1 through Month 6 via e-mails and web-based meetings HF Network members at the intervention facilities were encouraged to (a) enroll own facility on the national H2H website, and (2) initiate and/or plan projects focusing on 3 key areas. In Months 6 members of both the intervention and control facilities were asked to complete a survey to find out (1) enrollment status and (2) number of projects initiated and/or planned for the VA H2H initiative, and other ongoing projects focusing on reducing HF readmissions. Results: The survey response rate was 37% (intervention n=24, 59%; and control n=21, 34%). It was seen that 33 intervention and 6 control facilities enrolled on the national H2H website. Self-reported data indicated that the intervention facilities had a total of 163 projects: 73=initiated and/or planned VA H2H projects, and 90=other ongoing projects. In sharp contrast, the control facilities had a significantly less number of total 66 projects: 25=initiated and/or planned VA H2H projects and 41=other ongoing projects. Conclusions: The findings show that the facilitation of the VA H2H initiative through its HF Provider Network was very successful in terms of increased enrollment and significantly larger number of projects to reduce HF readmissions. Impact: Facilitation of non-mandated QI initiatives is crucial to improve the quality of care for HF patients.