BACKGROUND: Despite evidence-based national guidelines for optimal treatment of heart failure (HF), the quality of care remains inadequate. We sought to evaluate the effect of a national hospital-based initiative on quality of care in patients hospitalized with HF. METHODS: Two hundred fifty-nine US hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) submitted data on 48 612 patients with HF from March 1, 2003, through December 31, 2004. Admission, hospital, discharge care, and outcomes data were collected using a Web-based registry that provided real-time feedback on performance measures benchmarked to other hospitals. Process-of-care improvement tools, including evidence-based best-practice algorithms and customizable admission and discharge sets, were provided. RESULTS: Provision of complete discharge instructions and smoking-cessation counseling increased significantly (from 46.8%-66.5% and 48.2%-75.6%, respectively; P < .001 for both). Left ventricular function assessment started at a high rate (89.3%) and improved to 92.1% (P < .001). Angiotensin-converting enzyme inhibitors were prescribed at discharge to 75.8% of eligible patients, which did not improve during the 2-year study. There were trends for reduction of in-hospital mortality, postdischarge death, and combined postdischarge death and rehospitalization and a significant reduction in mean length of stay. Use of preprinted admission order sets and/or discharge checklists increased from 35.6% to 54.1% and was associated with an increase in the use of evidence-based therapies and lower risk-adjusted in-hospital mortality. CONCLUSIONS: Participation in OPTIMIZE-HF was associated with an increase in use of evidence-based therapy, adherence to performance measures, and shorter lengths of stay in patients hospitalized with HF. Increased use of process-of-care improvement tools was associated with further improvements in quality of care. TRIAL REGISTRATION: clinicaltrials.gov Identifier NCT00344513.
BACKGROUND: Despite evidence-based national guidelines for optimal treatment of heart failure (HF), the quality of care remains inadequate. We sought to evaluate the effect of a national hospital-based initiative on quality of care in patients hospitalized with HF. METHODS: Two hundred fifty-nine US hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) submitted data on 48 612 patients with HF from March 1, 2003, through December 31, 2004. Admission, hospital, discharge care, and outcomes data were collected using a Web-based registry that provided real-time feedback on performance measures benchmarked to other hospitals. Process-of-care improvement tools, including evidence-based best-practice algorithms and customizable admission and discharge sets, were provided. RESULTS: Provision of complete discharge instructions and smoking-cessation counseling increased significantly (from 46.8%-66.5% and 48.2%-75.6%, respectively; P < .001 for both). Left ventricular function assessment started at a high rate (89.3%) and improved to 92.1% (P < .001). Angiotensin-converting enzyme inhibitors were prescribed at discharge to 75.8% of eligible patients, which did not improve during the 2-year study. There were trends for reduction of in-hospital mortality, postdischarge death, and combined postdischarge death and rehospitalization and a significant reduction in mean length of stay. Use of preprinted admission order sets and/or discharge checklists increased from 35.6% to 54.1% and was associated with an increase in the use of evidence-based therapies and lower risk-adjusted in-hospital mortality. CONCLUSIONS: Participation in OPTIMIZE-HF was associated with an increase in use of evidence-based therapy, adherence to performance measures, and shorter lengths of stay in patients hospitalized with HF. Increased use of process-of-care improvement tools was associated with further improvements in quality of care. TRIAL REGISTRATION: clinicaltrials.gov Identifier NCT00344513.
Authors: John R Kapoor; Roger Kapoor; Anne S Hellkamp; Adrian F Hernandez; Paul A Heidenreich; Gregg C Fonarow Journal: J Am Coll Cardiol Date: 2011-09-27 Impact factor: 24.094
Authors: Christopher M O'Connor; Wei Jiang; Maragatha Kuchibhatla; Susan G Silva; Michael S Cuffe; Dwayne D Callwood; Bosh Zakhary; Wendy Gattis Stough; Rebekka M Arias; Sarah K Rivelli; Ranga Krishnan Journal: J Am Coll Cardiol Date: 2010-08-24 Impact factor: 24.094
Authors: Sana M Al-Khatib; Anne S Hellkamp; Adrian F Hernandez; Gregg C Fonarow; Kevin L Thomas; Hussein R Al-Khalidi; Paul A Heidenreich; Stephen Hammill; Clyde Yancy; Eric D Peterson Journal: Circulation Date: 2012-01-27 Impact factor: 29.690
Authors: Tanya R Gure; Ryan J McCammon; Christine T Cigolle; Todd M Koelling; Caroline S Blaum; Kenneth M Langa Journal: Circ Cardiovasc Qual Outcomes Date: 2012-05
Authors: Mihai Gheorghiade; Muthiah Vaduganathan; Andrew Ambrosy; Michael Böhm; Umberto Campia; John G F Cleland; Francesco Fedele; Gregg C Fonarow; Aldo P Maggioni; Alexandre Mebazaa; Mandeep Mehra; Marco Metra; Savina Nodari; Peter S Pang; Piotr Ponikowski; Hani N Sabbah; Michel Komajda; Javed Butler Journal: Heart Fail Rev Date: 2013-03 Impact factor: 4.214
Authors: Mihai Gheorghiade; Muthiah Vaduganathan; Stephen J Greene; Robert J Mentz; Kirkwood F Adams; Stefan D Anker; Malcolm Arnold; Fabio Baschiera; John G F Cleland; Gadi Cotter; Gregg C Fonarow; Christopher Giordano; Marco Metra; Frank Misselwitz; Eva Mühlhofer; Savina Nodari; W Frank Peacock; Burkert M Pieske; Hani N Sabbah; Naoki Sato; Monica R Shah; Norman L Stockbridge; John R Teerlink; Dirk J van Veldhuisen; Andrew Zalewski; Faiez Zannad; Javed Butler Journal: Heart Fail Rev Date: 2014-03 Impact factor: 4.214
Authors: Anubha Agarwal; Ehete Bahiru; Sang Gune Kyle Yoo; Mark A Berendsen; Sivadasanpillai Harikrishnan; Adrian F Hernandez; Dorairaj Prabhakaran; Mark D Huffman Journal: Heart Date: 2019-01-30 Impact factor: 5.994