多区域实施倡议对心力衰竭住院患者指导方针基础的绩效衡量措施的影响: IMPLEMENT-HF
Andrew J Sauer1, Chandler Beon2, Sruthi Cherkur2
1Saint Luke's Mid-America Heart Institute, Kansas City, MO (A.J.S., J.S.).
Circulation. Heart failure
|March 21, 2025
概括
通过IMPLEMENT-HF质量改善倡议,心力衰竭患者的四重医学疗法 (QMT) 使用显著增加. 这种协作方法提高了在常规实践中遵循指导方针的医疗治疗.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 四重医学疗法 (QMT) 提供了心力衰竭的生存益处,减少排气分数 (HFrEF),但未得到充分利用.
- IMPLEMENT-HF倡议旨在通过增加临床实践中的QMT采用来改善HFrEF护理.
研究的目的:
- 评估IMPLEMENT-HF质量改善计划在提高HFrEF患者的QMT利用方面的有效性.
- 评估QMT遵守的变化,并确定不同地区的护理差异.
主要方法:
- 来自61家医院的HFrEF患者的分析参与了美国心脏协会的Get With The Guidelines-HF和IMPLEMENT-HF.
- 多区域质量改进协作使用多学科学习和现场级反.
- 从2021年第一季度到2023年第二季度,收集有关退院时和退院后30天QMT利用率的数据.
主要成果:
- 在出院时使用无缺陷的QMT从4.7%增加到44.6% (P<0.0001).
- 退院30天后使用QMT的情况从0%提高到44.8% (P<0.0001).
- 在各个人口群体中,改善趋势是一致的,但仍然存在显著的区域差异.
结论:
- 在IMPLEMENT-HF倡议中,符合条件的HFrEF患者中,QMT使用量显著增加.
- 一个学习协作模式有效地促进了指导方针导向的医学治疗遵守的改进.
- 质量改善举措对于将基于证据的治疗转化为常规心血管护理至关重要.
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