title: Impact of an expanded hospital recognition program for heart failure quality of care.
abstract: BACKGROUND
  In 2009, the Get With The Guidelines-Heart Failure program enhanced the standard recognition of hospitals by offering additional recognition if hospitals performed well on certain quality measures. We sought to determine whether initiation of this enhanced recognition opportunity led to acceleration in quality of care for all hospitals participating in the program.
  
  
  RESULTS
  We examined hospital-level performance on 9 quality-of-care (process) measures that were added to an existing recognition program (based on existing published performance measures). The rate of increase in use over time 6 months to 2 years after the start of the program was compared with the rate of increase in use for the measures during the 18-month period prior to the start of the program. Use increased for all 9 new quality measures from 2008 to 2011. Among 4 measures with baseline use near or lower than 50%, a statistically significant greater increase in use during the program was seen for implantable cardioverter defibrillator use (program versus preprogram use: odds ratio 1.14, 95% CI 1.06 to 1.23). Among the 5 measures for which baseline use was 50% or higher, the increase in influenza vaccination rates actually slowed. There was no evidence of adverse impact on the 4 established quality measures, a composite of which actually increased faster during the expanded program (adjusted odds ratio 1.08, 95% CI 1.01 to 1.15).
  
  
  CONCLUSIONS
  A program providing expanded hospital recognition for heart failure had mixed results in accelerating the use of 9 quality measures.
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA (P.A.H.).
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.affiliation: Duke Clinical Research Institute, Durham, NC (X.Z., A.F.H.).
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Duke Clinical Research Institute, Durham, NC (X.Z., A.F.H.).
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.affiliation: Bluhm Cardiovascular Institute Northwestern University, Northwestern Memorial Hospital, Chicago, IL (C.W.Y.).
authors.forename: Clyde W
authors.initials: CW
authors.lastname: Yancy
authors.affiliation: Massachusetts General Hospital, Boston, MA (L.H.S.).
authors.forename: Lee H
authors.initials: LH
authors.lastname: Schwamm
authors.affiliation: Cleveland Clinic, Cleveland, OH (N.M.A.).
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.affiliation: University of California Los Angeles, Los Angeles, CA (G.C.F.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016507:Cardiology Service, Hospital / Q000592:standards*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017410:Practice Guidelines as Topic / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards; D017064:Process Assessment, Health Care / Q000592:standards*; D015397:Program Evaluation; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: awards; healthcare quality assessment; healthcare quality indicators; heart failure