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Objectives:The US Department of Veterans Affairs (VA) has been a leader in the use of Home Telehealth (HT) to monitor the health status and promote self-care for Veterans. VA’s HT services use standardized Disease Management Protocols (DMP) and telehealth technologies to target care and case management to improve access to care, improving the health of veterans. With HT, the location of health care services shift to the homes of Veterans receiving routine care. Current technologies include in-home devices from six vendors that ask the patient several daily questions regarding symptoms and vital signs and return the answers to the medical record.

Objective:The goal of the Dept. of Veterans Affairs (VA) Chronic Heart Failure (CHF) QUERI program is to improve the quality of care for heart failure (HF) patients and implement evidence-based practices throughout the VA system. One strategy to achieve this goal was to create a VA heart failure provider Network which occurred in 2006. We sought to characterize provider participation in this mature network.

Objective:The Department of Veterans Affairs (VA) joined the American College of Cardiology and the Institute for Health Care Improvement’s in their Hospital To Home (H2H) initiative. This initiative attempts to improve the transition of care following discharge for patients with acute myocardial infarction and Heart Failure. The Chronic Heart Failure (CHF) Quality Enhancement Research Initiative (QUERI) worked with providers at each VA hospital to encourage facility enrollment. Ultimately, 86 VA facilities enrolled. The purpose of this study was to determine the extent of existing quality improvement projects in place at each of the 86 enrolled facilities.

Objective:Over the past few years the VA Chronic Heart Failure (CHF) QUERI has been facilitating national initiatives like the Save 5 Million Lives Campaign and Hospital To Home (H2) with specific focus on inpatients, discharge process and follow up HF care. Survival following discharge has improved though it is not clear if discharge policies have changed.

Background:Mortality and readmission at 30 days following admission for heart failure (HF) and acute myocardial infarction (AMI) are now publically reported for US hospitals. It is unclear if outcome is similar for veteran (VA) and non-VA facilities.

Objective:Heart failure (HF) has been the number one reason for admission among Medicare patients and those in the Veterans Affairs (VA) Health Care System. Through multi-level and multi-facility evidence-based interventions, the Chronic Heart Failure (CHF) QUERI has been facilitating best practices for HF care at all the VA facilities. Mortality for patients with heart failure has been improving but it is unclear if this has been associated with improved processes of care. The goal of this study was to assess changes in the structures and processes of HF care from 2008 to 2011 at all the VA facilities.

Background:Mortality and readmission at 30 days following admission for heart failure (HF) and acute myocardial infarction (AMI) are publically reported. It is unclear if these are influenced by similar (correlated) or different care processes (not correlated).

ObjectivesHeart 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. In July 2006 the Chronic Heart Failure (CHF) Quality Enhancement Research Initiative (QUERI) formed the HF Network - a network of VA providers interested in improving HF care. Over 510 providers from 150 facilities are members of the network. However, the participants' views of the network are poorly understood.