SHM Converge Scientific Abstract ePoster Gallery-Hammering Heart Failure: Exploring Which Interventions Improve Heart Failure Hospitalization Outcomes Across Twenty Hospitals

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This study examined whether a hospital-wide effort could improve heart-failure outcomes across 20 hospitals. The intervention started with education and incentives, followed later by EHR-based clinical decision support (CDSS) added only in Epic hospitals, creating a natural comparison with Cerner hospitals and a control group where no intervention applied.<br /><br />Using Vizient data, the team analyzed 17,692 patients for mortality index (MORTi) and 17,280 for 30-day readmission index (30Di). Seasonal controls were used to compare Pre1 vs Post1 and Pre2 vs Post2 periods.<br /><br />Overall, education and incentives had limited impact on mortality but appeared to improve readmission outcomes. In the Post1 vs Pre1 comparison, Epic hospitals showed a modest MORTi reduction (ratio 0.97) and improved 30Di (0.97). Cerner hospitals had a higher MORTi ratio (1.11) but better 30Di (0.74), while control hospitals had lower MORTi (0.66) and worse 30Di (1.17).<br /><br />After CDSS was added in Post2, Epic hospitals showed the most notable mortality improvement, with a MORTi ratio of 0.68, compared with 1.55 in Cerner hospitals and 1.23 in controls. Readmission changes were smaller: Epic 0.89, Cerner 0.82, and control 1.03.<br /><br />The authors conclude that education and incentives may help reduce readmissions, but the EHR CDSS addition was associated with a substantial reduction in heart-failure mortality index in Epic hospitals. They suggest the benefit may have come from CDSS prompts emphasizing diuretics, guideline-directed medical therapy, and better complexity capture. If sustained, the observed 32% relative reduction in MORTi could have meaningful national impact.

Asset Subtitle

Alan Kubey

Meta Tag

Author List Alan Kubey, Andres Alvarado, Cara Martino, Charlotte Sacksteder, Dana M. Jordan, Heather Morgan, Jared Vanderzell, Jeffrey Riggio, Matthew Metzinger, Patricia Henwood, Thomas Buckwalter

Category Research

Concept Heart Failure Mortality Index

Concept 30-Day Readmission

Concept Clinical Decision Support

Concept Education

Concept Incentives

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University and Mayo Clinic

Presenting Author Alan Kubey

Track Quality Improvement

Keywords

heart failure

mortality index

readmission

clinical decision support

EHR

Epic hospitals

Cerner hospitals

hospital intervention

guideline-directed medical therapy

diuretics

Heart Failure Mortality Index

30-Day Readmission

Clinical Decision Support

Education

Incentives