Quality improvement in heart failure

Abstract This chapter explores quality improvement in heart failure. Over the last thirty years, much progress has been made in the diagnosis and treatment of heart failure. Yet registries repeatedly show that uptake of known disease-modifying therapies is far short of the benchmarks set by clinical trials; and real-world outcomes are much poorer than those seen in the clinical trials. This led healthcare professionals to start focusing on quality improvement in heart failure to try and translate evidence-based-medicine for heart failure into improved outcomes for patients. Quality improvement initiatives to date include setting standards of care for heart failure; implementing multi-professional heart failure care; specialization and training for heart failure healthcare professionals; and auditing and benchmarking. An ideal heart failure service should include specialist heart failure cardiologists and nurses, function across sectors of care, incorporate heart failure clinics, and adhere to common guidelines. Ultimately, the goal of heart failure services and quality improvement programmes is to ensure that wherever patients with heart failure begins their health care journey, they see the correct people to make an accurate and timely diagnosis, instigate the most appropriate investigations to ascertain the aetiology, and facilitate the introduction of evidence-based therapy, for all patients and not just a selected few.