Rationale and design of the National Benchmarking and Evidence-based National Clinical Guidelines for Chronic Heart Failure Management Programs Study.
OBJECTIVE
The National Benchmarks and Evidence-Based National Clinical Guidelines for Heart Failure Management Programs Study is a national, multicenter study designed to determine the nature, range, and effect of interventions applied by chronic heart failure management programs (CHF-MPs) throughout Australia on patient outcomes. Its primary objective is to use these data to develop national benchmarks and evidence-based clinical guidelines and optimize their cost-effective application by reducing quality and outcome variability.


METHODS
Primary data will be collected from CHF-MP coordinators and CHF patients enrolled in these programs on a national basis. Secondary outcome data will be collected from a national morbidity record and from patients' medical records.


METHODS
Stage I of the study involves a prospective clinical audit of all CHF-MPs throughout Australia (n = 45) to determine the extent of variability in programs currently. Stage II is a prospective cross-sectional survey design enrolling 1,500 patients (average of 40 patients per program) to firstly determine the typical profile of patients being managed via a CHF-MP in Australia and, secondly, the subsequent morbidity and mortality during the 6-month follow-up. Outcome data will be subject to multivariate analysis to determine the key components of care in this regard. All study data will be then examined in the final stage of the study (III) to develop national benchmarks for the application and auditing of CHF-MPs in Australia.


CONCLUSIONS
Variability in patient outcomes is a product of heterogeneity among CHF-MPs. The development of national benchmarks will minimize such heterogeneity and will provide a greater level of evidence for their cost-effective application.
Driscoll
Andrea
A
School of Nursing, Deakin University, Melbourne, Australia.
Worrall-Carter
Linda
L
Stewart
Simon
S
D001315:Australia; D019985:Benchmarking; D015340:Epidemiologic Research Design; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000451:nursing / Q000628:therapy*; D006801:Humans; D008485:Medical Audit; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic