Inpatients with Heart Failure Care pathway

Heart failure (HF) mortality is rising despite robust evidence-based guidelines. Hospitalization presents an opportune time to optimize care. Inpatient care pathways (CP) embedded in the electronic health record (EHR) can enhance adherence to guidelines by providing real-time decision support. To measure the impact of the heart failure reduced ejection fraction (HFrEF) CP on early diuretic use, goal-directed medical therapy (GDMT), and referral to comprehensive HF management (CHFM) on discharge. This dataset provides information about patients admitted to a tertiary care hospital. We used this data to conduct a retrospective cohort study of all the HF hospitalizations two years after pathway implementation and further limited the cohort to those with ejection fraction (EF) \u2264 40%. We compared rates of early diuretic use, GDMT, and referral to CHFM between cohorts defined by pathway use. We found that despite low utilization, pathway use was associated with more early diuretics and referrals to CHFM with a trend toward more GDMT on discharge. CPs are a feasible strategy to optimize care for hospitalized HF patients.