An introduction to the collaborative methodology and its potential use for the management of heart failure.
BACKGROUND
Heart failure (HF) is responsible for significant disease burden in developed countries internationally. Despite significant advances and a strong evidence base in therapies and treatment strategies for HF, access to these therapies continues to remain elusive to a significant proportion of the HF population. The reasons for this are multifactorial and range from the financial cost of treatments to the individual attitudes and beliefs of clinicians. The collaborative methodology, based upon a quality improvement philosophy, has been identified as a potentially useful tool to address this treatment gap.


OBJECTIVE
In this manuscript, we review the published literature on the collaborative methodology and assess the evidence for achieving improvement in the management of HF.


METHODS
Searches of electronic databases, the reference lists of published materials, policy documents, and the Internet were conducted using key words including "collaborative methodology," "breakthrough series," "quality improvement," "total quality improvement," and "heart failure." Because of the paucity of high-level evidence, all English-language articles were included in the review.


RESULTS
On the basis of the identified search strategy, 43 articles were retrieved. Key themes that emerged from the literature included the following: (1) The collaborative methodology has a significant potential to reduce the treatment gap. (2) Leadership is an important characteristic of the collaborative method. (3) The collaborative methodology facilitates sustainability of the quality improvement process.


CONCLUSIONS
The collaborative methodology, when implemented and conducted according to key conceptual principles, has significant potential to improve the outcomes of patients, particularly those with HF and chronic cardiovascular disease.
Newton
Phillip J
PJ
School of Nursing, Family and Community Health, College of Social and Health Science, University of Western Sydney, West Area Health Service, New South Wales, Australia. phil_newton@wsahs.nsw.gov.au
Davidson
Patricia M
PM
Halcomb
Elizabeth J
EJ
Denniss
A Robert
AR
Westgarth
Fidye
F
D003299:Cooperative Behavior; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007857:Leadership; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods*; D014481:United States