SHM Converge Scientific Abstract ePoster Gallery-Assessing the Impact of an Electronic Health Record Intervention on Guideline-Directed Medical Therapy Prescribing in Heart Failure Among Community Versus Academic Hospitals

Assessing the Impact of an Electronic Health Record Intervention on Guideline-Directed Medical Therapy Prescribing in Heart Failure Among Community Versus Academic Hospitals

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This study examined whether quality improvement interventions changed discharge prescribing of guideline-directed medical therapy (GDMT) for heart failure differently in academic versus community hospitals.<br /><br />Using a unified Epic electronic health record across 10 hospitals (3 academic, 7 community), the team reviewed 3,535 patients discharged with a primary heart failure diagnosis from July 2023 to June 2025. Two intervention phases were evaluated: Phase 1 included financial incentives and systemwide heart failure workgroups (July–October 2024), and Phase 2 added clinical decision support and heart failure order sets (December 2024–June 2025). Outcomes included the average number of GDMT agents prescribed, use of all four GDMT “pillars” in HFrEF/HFimpEF, and SGLT2 inhibitor prescribing in HFpEF/HFmrEF.<br /><br />Results showed that community hospitals responded more strongly to the Phase 1 education/incentive approach. In HFrEF/HFimpEF patients, the mean number of GDMT medications increased from 2.19 to 2.44 in community hospitals (p=0.0028), compared with 2.32 to 2.38 in academic hospitals (p=0.46). In Phase 2, academic hospitals showed a larger improvement with EHR-based tools, increasing from 2.27 to 2.48 GDMT agents (p=0.0009), while community hospitals had a smaller, borderline change from 2.35 to 2.47 (p=0.053).<br /><br />Overall, the findings suggest that institutional context matters: community hospitals may respond better to education and incentives, whereas academic hospitals may benefit more from electronic decision support. The authors conclude that systemwide heart failure improvement efforts should be tailored to hospital type to maximize effectiveness.

Asset Subtitle

Trisha Sindhu

Meta Tag

Author List Alan A. Kubey, Charlotte Pirquet, Charlotte Sacksteder, Sheraz Qamar, Tanay-Veer Gandhi, Trisha Sindhu

Category Research

Concept Guideline-Directed Medical Therapy

Concept Heart Failure

Concept Discharge Prescribing

Concept Quality Improvement

Concept Study Design

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University Hospital

Presenting Author Trisha Sindhu

Track Quality Improvement

Keywords

heart failure

guideline-directed medical therapy

GDMT

quality improvement

academic hospitals

community hospitals

electronic health record

clinical decision support

heart failure order sets

SGLT2 inhibitors

Guideline-Directed Medical Therapy

Heart Failure

Discharge Prescribing

Quality Improvement

Study Design