SHM Converge Scientific Abstract ePoster Gallery-Improving Iv Iron Utilization in Heart Failure Exacerbations

Pdf Summary

This quality improvement project from Baylor College of Medicine evaluated whether education and workflow changes could improve intravenous (IV) iron use in patients hospitalized for heart failure with reduced ejection fraction (HFrEF) and iron deficiency.<br /><br />Evidence from prior trials and updated heart failure guidelines supports IV iron for symptomatic patients with iron deficiency, even without anemia, but real-world use is unclear. The team reviewed all relevant heart failure admissions before and after an intervention period. Proper screening meant having a recent echocardiogram and iron studies; proper treatment meant receiving at least one dose of IV ferric gluconate before discharge. The intervention included resident education through presentations, emails, and flyers, followed eight months later by an electronic medical record order set.<br /><br />At baseline, 54% of HFrEF admissions were screened for iron deficiency, 32% of iron-deficient patients received IV iron, and 30-day readmission for recurrent CHF was 27%. After the intervention, screening increased to 61%, treatment increased to 41%, and 30-day readmissions fell to 14%.<br /><br />Early after the intervention, screening improved significantly, and treatment showed a positive trend. However, by 19 months, screening and treatment gains had faded, likely due to declining awareness over time and staff turnover, especially with a new intern class. In contrast, the reduction in readmissions continued and became statistically significant by 19 months.<br /><br />The authors conclude that IV iron use may reduce short-term readmissions in HFrEF, but sustained improvement requires ongoing education, reinforcement of guidelines, and regular training updates.

Asset Subtitle

Richard Bui

Meta Tag

Author List David Wharton, Ebubechi Adindu, Frederick B. Peng, Julliet Ogu, Lindsay Vaclavik, Michael Gillette, Molly Horstman, Richard Bui, Savitri Fedson

Category Innovations

Concept Intravenous Iron

Concept Heart Failure with Reduced Ejection Fraction

Concept Iron Deficiency

Concept Clinical Benefit

Concept Guideline

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author Richard Bui

Track Quality Improvement

Keywords

heart failure with reduced ejection fraction

intravenous iron

iron deficiency

quality improvement

Baylor College of Medicine

screening

ferric gluconate

resident education

electronic medical record order set

readmission reduction

Intravenous Iron

Heart Failure with Reduced Ejection Fraction

Iron Deficiency

Clinical Benefit

Guideline