SHM Converge Scientific Abstract ePoster Gallery-Splitting Hairs in Heart Failure: Exploring Which Ehr Interventions Improve Heart Failure Hospitalization Outcomes Across Ten Hospitals

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This study examined whether two EHR-based interventions improved outcomes for hospitalized heart failure patients across 10 hospitals: a novel admission order set designed to promote early diuresis and guideline-directed medical therapy (GDMT), and a templated note (HFNOTE) that centralized key clinical data and helped capture patient complexity.<br /><br />Using data from a “Post2” period (12/1/24–6/30/25), the team matched Vizient outcome data with EHR data and analyzed results descriptively. A total of 4,865 patients were included.<br /><br />Overall, the Post2 mortality index (MORTi) was 0.83, indicating lower observed mortality than expected, while the 30-day readmission index (30Di) was 1.07, indicating slightly higher readmissions than expected.<br /><br />When stratified by intervention use:<br />- Order set use was associated with lower mortality index than no use (0.66 vs 0.91), but slightly higher 30-day readmission (1.12 vs 1.04).<br />- HFNOTE use was associated with an even lower mortality index than no note use (0.50 vs 1.12), while 30-day readmission was similar between groups (1.08 vs 1.06).<br /><br />The authors note that these findings are promising but likely influenced by confounding factors, such as differences in patient location and severity of illness. They suspect HFNOTE may be used more often in less acute settings and may better capture complexity, which could affect apparent mortality associations. They also believe the admission order set may be contributing to improved mortality through earlier diuresis, though the higher readmission rate may not be causal.<br /><br />Overall, the intervention period was associated with a substantial reduction in mortality compared with a seasonally adjusted comparator, but the true effects of each intervention still need to be isolated with more rigorous analysis.

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 Inpatient Care

Concept Inpatient Mortality Metrics

Concept 30-Day Readmission

Concept EHR Intervention

Concept Order Set

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University and Mayo Clinic

Presenting Author Alan Kubey

Track Technology in Hospital Medicine

Keywords

heart failure

EHR interventions

admission order set

HFNOTE

mortality index

readmission index

guideline-directed medical therapy

early diuresis

hospitalized patients

confounding factors

Heart Failure Inpatient Care

Inpatient Mortality Metrics

30-Day Readmission

EHR Intervention

Order Set