Multiregional Implementation Initiative’s Impact on Guideline-Based Performance Measures for Patients Hospitalized With Heart Failure: IMPLEMENT-HF

Figures

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  Figure 1.. Participating IMPLEMENT-HF sites. Sites participating in the IMPLEMENT-HF initiative included hospitals, clinics, skilled nursing facilities, and mobile integrated healthcare. For this analysis, only hospital data were included as the Get With The Guidelines–Heart Failure registry is designed for hospital data collection.

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  Figure 2.. Categories of implementation initiative activities: quality improvement strategies utilized by participating sites during the IMPLEMENT-HF initiative (specific domains, definitions, and initiative examples are outlined in Figures S1A, S1B, and S2). Data abstraction best practices were shared with sites to allow report generation and dash boarding in real time to allow for targeted interventions. Model sharing existed locally and initiative-wide, focusing on opportunities to improve systems of care involving targeted protocols, documentation improvements, standardizing order sets, and/or smart phrases. System modification categories of intervention included targeting domains involved with care pathway protocols, documentation standards, electronic medical records, pharmacy formularies, etc. Education and resources focused on how to support both the care team and the patient.

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  Figure 3.. Inpatient measures adherence by quarter from Q1 2021 to Q3 2023. Adherence rate at hospital discharge by quarter for associated inpatient process of care metrics during the IMPLEMENT-HF initiative. ACE indicates angiotensin-converting enzyme; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor–neprilysin inhibitor; HFrEF, heart failure with reduced ejection fraction; MRA, mineralocorticoid antagonist; and SGLT2, sodium-glucose cotransporter 2.

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  Figure 4.. Thirty-day measures adherence by quarter from Q1 2021 to Q3 2023. Adherence rate by quarter for the associated postdischarge process of care metrics during the IMPLEMENT-HF initiative. ACE indicates angiotensin-converting enzyme; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor–neprilysin inhibitor; HFrEF, heart failure with reduced ejection fraction; LVSD, left ventricular systolic dysfunction; MRA, mineralocorticoid antagonist; and SGLT2, sodium-glucose cotransporter 2.