3019 — CHF-QUERI: Evaluation of the Implementation of the Heart Failure Network of VA Providers

Sahay A (CHF-QUERI), Massie B (CHF-QUERI), Heidenreich P (CHF-QUERI)

Objectives:
According to Rogers’ diffusion of innovation theory, social networks significantly affect performance and innovation. They are a valuable tool for information sharing and to identify opinion leaders or local champions. For successful evidence-based implementation the PARIHS framework emphasizes the function of the dynamic relationships among evidence, context and facilitation. Heart failure (HF) is associated with high mortality and poor quality of life. Moreover, it is the most common medical reason for admission within and outside of the VA health care system. With support from the Office of Patient Care Services, in July 2006 CHF-QUERI formed the HF Network – a network of VA providers interested in improving HF care. Over 360 providers from 167 facilities are members of the network. The purpose of this research was to do a formative evaluation to assess the effectiveness of the HF Network in the context of its goals which include sharing knowledge and experiences about different HF programs, creating cultures to identify and involve local champions to initiate innovation, and understand facilitators and barriers to enable implementation of evidence into practice.

Methods:
All 360 members of the HF Network were invited by email to complete a web-based survey. Members were asked if participation was helpful with understanding barriers to improved clinical care, whether participation influenced them, or helped them to influence others.

Results:
A total of 115 members responded for a 32% response rate. Respondents reported the HF Network helped them understand facilitators and barriers in setting up or running HF clinic/program (92%), validated their own current practice for patients with HF (91%), provided names of contacts for networking and potential problem solving (91%), and helped solve implementation-related problems at their facility (66%). Interestingly, respondents who reported that they considered their participation in the network as beneficial also perceived themselves as influential in making changes at their own facility to improve care (r=.859, p < 0.01).

Implications:
Members of the HF Network perceived their involvement in the network’s activities as helpful. The network was most beneficial to those who perceived themselves as influential.

Impacts:
Through such social networks providers get unique opportunities to implement changes for improved care of patients.