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Health Services Research & Development

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2008 HSR&D National Meeting Abstract

National Meeting 2008

1045 — Heart Failure Network of VA Providers: An Innovative Strategy for Implementation

Sahay A (Chronic Heart Failure (CHF) QUERI), Massie BM (CHF QUERI), Heidenreich PA (CHF QUERI)

Social networks are a valuable tool for information sharing and to identify key actors - such as opinion leaders or local champions, and to identify subgroups within larger systems. These invisible social networks, as described by Rogers’ diffusion of innovation theory, significantly affect performance and innovation. Heart failure (HF) is associated with high mortality and poor quality of life. Moreover, it is the most common medical reason for admission within and outside of the VA health care system. An initial goal of the Chronic Heart Failure Quality Enhancement Research Initiative (CHF-QUERI) was to form a HF Network of VA providers to 1) understand local perception of the need to improve care, 2) understand barriers to improved care, and 3) implement proven health services interventions. Such a HF Network could provide the opportunity to identify and involve opinion leaders and/or local champions at the VA facilities to initiate innovation as well as influence non-adopters.

With support from VA’s Patient Care Services, CHF QUERI initiated the HF Network – a network of VA providers interested in improving HF care. Providers include Chiefs of Medicine, Chiefs of Cardiology, clinicians, researchers, NPs, PAs, etc. from VA Medical Centers and VA Health Care Systems. This network was initiated with a single email to all known heads of medicine or cardiology. We asked that the invitation be forwarded to all interested providers. The initial plans for the network included bi-monthly live meetings, annual in-person meetings at a major heart failure conference, and periodic web and email-based surveys.

Fifteen months after the initial introductory email, over 330 providers from 146 facilities are participating in the HF Network. Analysis shows that 1-8 members participate from each facility. Main achievements are: 245 (72%) members actively participate in live meetings and/or conference calls; 8 members have presented HF programs at their facilities focusing discussions on barriers and facilitators; 16 proposals have been submitted/funded establishing new affiliations; 3 ideas initiated by members are being discussed at VISN and national levels; an echocardiographer sub-network has been formed; and support of the Institute for Health Improvement’s 5 Million Lives Campaign has resulted in projects including a collaborative on early follow-up after discharge for patients with heart failure.

Involvement and active participation of the HF Network members is crucial to achieve the goals, particularly for the implementation of the projects at any level.

Such networks will be an innovative strategy for implementation to improve care of patients.

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