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.
BACKGROUND
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.


RESULTS
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 < or = .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.


CONCLUSIONS
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.
Baker
David W
DW
Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Il 60611, USA.
Asch
Steven M
SM
Keesey
Joan W
JW
Brown
Julie A
JA
Chan
Kitty S
KS
Joyce
Geoffrey
G
Keeler
Emmett B
EB
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011788:Quality of Life; D012648:Self Care; D020377:Self Efficacy