Improving Heart Failure Discharge Care Through a Resident-Led Quality Improvement Initiative

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  Visual Summary. Timeline of Our Resident-Led Quality Improvement Initiative Designed to Strengthen Heart Failure Discharge Care The project targeted modifiable discharge-level processes through standardized patient education using teach-back methodology and systematic review of guideline-directed medical therapy eligibility. Among patients receiving resident-led discharge education, lower observed 30-day readmission rates were noted compared with the hospital-wide baseline, despite persistent clinical barriers to full guideline-directed therapy. The initiative emphasizes feasibility, scalability, and integration into routine inpatient workflows. AHA = American Heart Association; AKI = acute kidney injury; GDMT = guideline-directed medical therapy; HF = heart failure; HFrEF = heart failure with reduced ejection fraction; PDSA = plan-do-study-act.

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  Figure 1. Percentage of Patients Readmitted Within 30 Days Bar chart showing the proportion of patients with heart failure who were readmitted within 30 days of discharge compared with those not readmitted within 30 days in the resident-covered cohort during the implementation period. Percentages reflect 30-day all-cause readmission status among patients who received the standardized discharge education intervention (n = 60).

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  Figure 2. Distribution of Patients by Type of CHF Bar chart showing the proportion of patients with heart failure with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF), and mildly reduced ejection fraction (HFmrEF) in the intervention cohort (n = 60). CHF = congestive heart failure.

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  Figure 3. HFrEF Patients Discharged on GDMT Bar chart showing the proportion of patients with heart failure with reduced ejection fraction (HFrEF) who were discharged on guideline-directed medical therapy (GDMT) compared with those who were not (n = 60).

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  Figure 4. Distribution of Patients by Number of GDMT Pillars Prescribed at Discharge Pie chart showing the distribution of patients with heart failure with reduced ejection fraction by the number of guideline-directed medical therapy (GDMT) pillars prescribed at hospital discharge (n = 60).

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  Figure 5. Distribution of GDMT Pillars Prescribed at Discharge Pie chart showing the proportion of patients with heart failure with reduced ejection fraction discharged on each foundational guideline-directed medical therapy (GDMT) class (n = 60). ACE = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker; ARNi = angiotensin receptor–neprilysin inhibitor; MRA = mineralocorticoid receptor antagonist; SGLT2i = sodium-glucose cotransporter 2 inhibitor.