Improving Iron Deficiency Screening in Veterans With Heart Failure.

BACKGROUND: Iron deficiency (ID) is common among patients with heart failure. It is associated with reduced functional capacity, recurrent hospitalization, and worse outcomes. Despite guideline recommendations, ID screening remains low in clinical practice. PROJECT RATIONALE: The aim was to improve adherence to guideline-recommended ID screening among ambulatory veterans with heart failure and left ventricular ejection fraction <50% through a clinician educational intervention. PROJECT SUMMARY: We conducted a single-center quality improvement initiative in a Veterans Affairs ambulatory cardiology clinic. Screening increased from 50.0% before the intervention to 68.3% afterward. Referral for intravenous iron therapy among eligible patients remained low but increased from 0% to 16.7%. Clinician education improved ID screening but had limited impact on treatment, highlighting the need for additional implementation strategies at the systems level. TAKE-HOME MESSAGES: ID screening represents an important opportunity to improve heart failure care. Educational interventions may increase screening, but standardized workflows may be needed to achieve meaningful improvements.