title: 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.
abstract: 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.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Il 60611, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Baker
authors.forename: Steven M
authors.initials: SM
authors.lastname: Asch
authors.forename: Joan W
authors.initials: JW
authors.lastname: Keesey
authors.forename: Julie A
authors.initials: JA
authors.lastname: Brown
authors.forename: Kitty S
authors.initials: KS
authors.lastname: Chan
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Joyce
authors.forename: Emmett B
authors.initials: EB
authors.lastname: Keeler
mesh_terms: 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