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• W2005339966 abstract "The purpose of the VA CHF QUERI Center's H2H initiative and Heart Failure (HF) Network is to implement the American College of Cardiology's and Institute for Healthcare Improvement's (IHI) national H2H initiative at VA facilities and reduce all-cause readmissions for HF patients. The aim of the VA H2H survey was to determine the impact of H2H implementation within an RCT design of 61 intervention and 61 control sites, including identifying barriers and facilitators of projects to improve the care transitions of HF patients. We surveyed 122 VA facilities through emails to designated clinician/administrative staff (N=598) 4-6 months following the VA H2H launch. Staff was asked to detail barriers and facilitators to implementing H2H projects in their VA facility. Respondents from 91 facilities identified 101 barriers and 60 facilitators to the uptake of the H2H initiative. Funding, resources, staffing, space, evaluation data, and lack of top leadership support were all cited as major barriers. Facilitators included strong senior leadership and internal H2H champions, the HF Provider Network, and effective interdisciplinary collaboration. A top barrier (n=47) was budgetary/resource constraints, including adding staff to meet increased demand for HF pre and post-discharge visits and care coordination. Staffing issues included a deficit of RNs, NPs, Case Managers, Program Coordinators, PharmD, and PCPs and Cardiology providers. Space limitations were a common barrier to HF clinic start-up or growth. Facility characteristics were the second most common H2H barrier (n=45). Barriers included organizational resistance to change; limited data; deficits in providers' clinical knowledge and skill; and suboptimal collaboration among disciplines and departments. Sites' lack of senior leadership support was cited as a critical uptake barrier. Role conflicts were reported between H2H clinic providers and VA home and community based services. Resource constraints, data limitations, collaboration deficits, and insufficient leadership support are four commonly reported barriers to uptake of the VA H2H initiative. Organizational leadership support and effective provider/staff collaboration are keys to successful H2H implementation." @default.
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• W2005339966 date "2011-08-01" @default.
• W2005339966 modified "2023-09-25" @default.
• W2005339966 title "Barriers and Facilitators to Implementing the 2010 Veteran's Administration (VA) CHF QUERI Hospital to Home (H2H) Initiative" @default.
• W2005339966 doi "https://doi.org/10.1016/j.cardfail.2011.06.253" @default.
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