Implementation of a heart failure disease management program in the rural southern United States: a best practice implementation project.

BACKGROUND Heart failure affects thousands of patients annually, often resulting in hospitalization, emergency room visits, and decreased quality of life. The scientific evidence indicates that disease management programs using a multidisciplinary approach improve outcomes for heart failure patients. AIM The overarching aim of this evidence implementation project was to establish a disease management program for heart failure patients. Specifically, the project sought to promote compliance with best practices for the early identification of heart failure exacerbation symptoms to prevent emergency room visits and hospitalizations, thereby reducing morbidity and mortality. METHODS This project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted, revealing the need for a heart failure disease management program. A policy was developed to implement a disease management program and virtual relationships were established to create a multidisciplinary team. A follow-up audit was conducted to determine whether the implemented interventions closed the gap in practice identified by the baseline audit. RESULTS The baseline audit revealed 0% compliance with best practices for the management of patients with heart failure, while the follow-up audit revealed 93.3% compliance. CONCLUSIONS This project enhanced best practices by implementing a protocol in a rural health clinic to ensure that all heart failure patients were enrolled in a disease management program. Recommendations include using the electronic health record to quickly identify heart failure patients and their status in a disease management program. Chart audits should be performed every 6 months to ensure the program's sustainability and to determine heart failure patients' enrollment status. SPANISH ABSTRACT http://links.lww.com/IJEBH/A270.