Differences in Education, Knowledge, Self-Management Activities, and Health Outcomes for Patients With Heart Failure Cared for Under the Chronic Disease Model: The Improving Chronic Illness Care Evaluation

• Published in: Journal of cardiac failure 2005-08, Vol.11 (6), p.405-413
• Main Authors: Baker, David W., Asch, Steven M., Keesey, Joan W., Brown, Julie A., Chan, Kitty S., Joyce, Geoffrey, Keeler, Emmett B.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Attitude to Health; Chronic care; Chronic Disease; Cross-Sectional Studies; Delivery of Health Care - utilization; Female; Health Care Surveys; Heart Failure - therapy; Humans; Knowledge; Male; Middle Aged; Nurse-Patient Relations; Outcome Assessment (Health Care); Patient Education as Topic; Patient Satisfaction; quality improvement; Quality of Life; Self Care; Self Efficacy; self-management
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2005.03.010

The objective of this study was to determine whether participation in a quality improvement (QI) collaborative for heart failure (HF) was associated with better interpersonal aspects of care and health outcomes. We conducted a cross-sectional telephone survey of patients in 6 organizations who participated in a QI collaborative for HF (participants, n = 387) and 6 comparable control organizations (controls, n = 414) and measured provider-patient communication, education received, knowledge of HF, self-management behaviors, satisfaction, and quality of life. The participant group patients were more likely to report their doctor and nurse discussed treatment options and reviewed self-management ( P < .01 for both). A total of 88% of participants were told to weigh themselves daily and record their weight compared with 34% of controls ( P < .01). Participants were more likely to know how often to check their weight ( P < .01), recognize symptoms of worsening HF ( P ≤ .01 for all), have a scale ( P = .002), and monitor their weight daily ( P < .001). Participants had similar quality of life but fewer emergency department visits and hospitalizations. Participation in a QI collaborative for HF was associated with better communication, education, and knowledge, and lower health care use. Collaboratives may be a useful method for disseminating quality improvement strategies.