Abstract P1069: Health Care Professional Perspectives on IMPLEMENT-HF: A Qualitative Study Examining Successes, Facilitators, and Barriers in a Quality Improvement Program for Patients with Heart Failure

Abstract

Introduction: Heart failure (HF) leads to over 1 million hospitalizations and 450,000 related deaths annually, yet there are substantial quality gaps in care. In 2021, the American Heart Association launched IMPLEMENT-HF (I-HF), a 3-year national Quality Improvement (QI) initiative, to improve care and outcomes for patients with HF. Several QI strategies were used and evaluated over the course of this initiative. Purpose: Focus groups were conducted to gather health care professional (HCP) perspectives on I-HF implementation. Results will assist in determining overall program impact and to identify successes, barriers, and facilitators to inform implementation of future QI programs. Methods: This study involved virtual focus groups (n=8) with HCPs (n=25) recruited from the 111 sites enrolled in I-HF. A semi-structured focus group guide was developed to facilitate the 60-minute sessions. Focus groups were recorded and transcribed, and inductive and deductive thematic analyses conducted in NVivo identified key high-level themes and subthemes. Results: HCPs felt I-HF improved their care team’s knowledge of HF treatment options and their confidence in treating patients with HF. They reported improvements in prescribing guideline-directed medical therapy (GDMT), medication adherence, and follow-up appointment attendance during the program period. HCPs appreciated the flexibility and variety of I-HF’s educational offerings, opportunities to learn from other HCPs, and the benefits of the Get With The Guidelines® program on patient care. Commonly cited implementation barriers included high staff turnover, clinical roles taking precedence, and a lack of leadership and organization within their sites, which hindered full engagement with I-HF. The cost of and lack of insurance coverage for GDMT was frequently cited as a major burden for patients and a barrier to uptake. Conclusions: QI programs like I-HF can improve care and outcomes for patients with HF and increase HCP knowledge and confidence in providing appropriate treatments. Several cited implementation facilitators, such as flexible educational offerings, can be replicated in future programs. Some reported barriers, such as limited staff capacity, will be challenging to address. However, future initiatives can offer additional guidance on program implementation and recommend assigning a point person at each site to enhance internal organization and support more comprehensive adoption of program activities.