Hammering Heart Failure: Exploring Which Interventions Improve Heart Failure Hospitalization Outcomes Across Twenty Hospitals.

BACKGROUND: Heart failure (HF) remains a leading cause of hospitalization, mortality, and readmission. Despite evidence-based therapies, achieving consistent system-wide implementation remains challenging. PROJECT RATIONALE: We evaluated the association of clinician education, incentive alignment, and electronic health record (EHR)-based clinical decision support systems (CDSS) with Vizient risk-adjusted mortality index and 30-day readmission index across a 20-hospital health system. PROJECT SUMMARY: Following a merger, hospitals served as natural control hospitals, received education/incentives alone (Cerner), or education/incentives plus EHR-CDSS (Epic). Education, incentives, and readmission case review were introduced on July 1, 2024, followed by HF-focused CDSS deployment in Epic on November 18, 2024. Compared with a seasonally matched controls, Epic hospitals demonstrated a 32% relative reduction in mortality index, whereas Cerner and control hospitals showed higher mortality ratios (1.55 and 1.23, respectively). TAKE-HOME MESSAGES: Education, incentives, and case review were associated with improved readmission performance, whereas EHR-based CDSS was associated with reductions in HF mortality, suggesting a scalable strategy to improve outcomes.