Abstract 14416: Strategies for Improving the Care of Patients Hospitalized With Heart Failure: Baseline Data From the CONNECT-HF Trial

IntroductionPatients hospitalized for heart failure (HF) are at an increased risk of rehospitalization and death following discharge. However, limited data exist to inform health systems on implementation of evidence-based quality improvement (QI) initiatives for the peri-discharge period.MethodsThe...

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Published in:Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A14416-A14416
Main Authors: Feng, Kent Y, Granger, Bradi B, Fonarow, Gregg C, Pina, Ileana L, Lewis, Eldrin F, Cooper, Lauren B, Allen, Larry A, Kaltenbach, Lisa A, Granger, Christopher B, Hernandez, Adrian F, DeVore, Adam D
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Language:English
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Summary:IntroductionPatients hospitalized for heart failure (HF) are at an increased risk of rehospitalization and death following discharge. However, limited data exist to inform health systems on implementation of evidence-based quality improvement (QI) initiatives for the peri-discharge period.MethodsThe CONNECT-HF trial is an ongoing, large-scale, pragmatic, cluster-randomized trial designed to evaluate the effect of a health-system level QI intervention compared to usual care on HF outcomes in the United States. Eligible hospitals were required to have the capacity to be randomized to a system-based QI intervention. We conducted a web-based survey of participating hospitals in the United States between June 1, 2017 and May 23, 2018 by asking QI leaders at each site to complete a questionnaire describing the site’s baseline hospital-based QI practices.ResultsOf 114 hospitals, 55% reported admitting most patients (>50%) diagnosed with decompensated HF to specialized HF units or care teams (Figure). Of participating hospitals, 56% have a system for various pre-discharge assessment and actions. For patients with HF who cannot see their primary provider within 7-10 days, 60% of hospitals have a post-discharge clinic to assist with the post-discharge transition, and 65% have clinics that can accommodate same-day or unscheduled outpatient HF visits. In terms of QI resources, 76% of hospitals have a QI team that focuses on HF care, and 45% participate in a government-sponsored or national professional society HF QI program.ConclusionAt baseline time of inclusion in the CONNECT-HF trial, wide variations in hospital care, discharge processes, outpatient follow-up, and QI participation among participating hospitals were identified. This suggests ample opportunity for continued refinement and improvement of HF care even among a proactive group of hospitals meeting criteria for enrollment in a trial of transitional care.
ISSN:0009-7322
1524-4539