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Heart failure (HF) represents an immense burden to our patients and, consequently, to health-care expenditure. In an era of pay-for-performance initiatives, during which financial penalties are enforced for HF-related readmissions, reducing these occurrences has become of paramount importance to hospital systems throughout the United States. In an effort to improve heart failure management as well as hospital readmission rates, the American Heart Association (AHA) created a collaborative quality improvement program titled “Get With the Guidelines - Heart Failure (GWG-HF).” It is the aim of this study to evaluate the efficacy of this initiative in reducing readmissions.
A university medical center in a major U.S. city performed a retrospective chart review of randomly selected HF hospitalizations on a yearly basis for the GWG-HF initiative. These data were used to compare two years, 2012 and 2016; one in which the hospital’s GWG-HF performance was subpar (2012, N=416) and the other in which performance warranted a Gold-Standard award for adherence to guidelines (2016, N=301). GWG-HF “Achievement Measures” were selected as comparative variables between the two years.
Of the GWG-HF “Achievement Measures,” post-discharge appointments displayed the most significant variance between the comparison groups: 97.3% in 2016 and only 74.6% in 2012 (p<0.0001, 95% CI 17.1-28.1). Additionally, evidence-based beta blocker use exhibited a statistically significant difference: 99.2% in 2016 and 91.8% in 2012 (p=0.0031, 95% CI 2.6-12.2). Measuring the LV function and ACEi/ARB/ARNi use were achievement measures with statistically insignificant differences in the two populations.
The GWG-HF “Achievement Measures” of scheduling post-discharge appointments, and utilizing evidence-based beta blockers were better enforced during a period with fewer 30-day readmissions. This correlation does not signify causation, but lends to the likelihood that compliance with GWG-HF ultimately reduces HF-related readmissions.