The Development and Evaluation of the Greater Manchester Heart Failure Investigation Tool (GM-HFIT)

A Catalyst for Service Improvement

Lorraine Burey, Kieley Lewthwaite, Dan Terry, Sam Lacey, Katy Rothwell, John Humphreys, Jack Adams, Caroline O'donnell, Penny A Cook, Christi M. Deaton, Felicity Astin

Research output: Contribution to journalMeeting Abstract

Abstract

Introduction Heart failure (HF) is a complex and highly debilitating clinical syndrome. Clear guidelines identify the optimum management of patients living with HF in primary settings but implementation of these is suboptimal.Aim The aim of this service improvement project was to develop a tool kit, The Greater Manchester Heart Failure Investigation Tool (GM-HFIT), to improve the ongoing management of people diagnosed with HF.Methods The GM-HFIT development was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. A prospective, pre-test, post-test design informed an audit conducted between 13th February 2012 and 12th December 2013 with data from two clinical commissioning groups (CCGs) across North West Manchester.Results Data from 1146 matched cases were analysed using McNemar tests (SPSS v20). Preliminary analysis suggests that at baseline, 22% of patients were not eligible to be on the HF register, which decreased to 15% after introduction of the tool (P < 0.001). The recording of blood pressure (BP) was high at both time points (95%), while the recording of pulse and rhythm improved from 58% to 64% and 44% to 49% respectively (P = 0.005). While control of BP remained the same (with 62% of patients with target BP <130/70), the proportion of patients receiving the target dose of ACE Inhibitors and beta blockers improved significantly (70% to 85% and 68% to 85% respectively, P < 0.001). In addition 578 missing patients were added to the heart failure register as a result of the case finding element of the project and a further 6 were recommended for further investigation before adding.Conclusion The GM-HFIT service improvment project led to improvements in identification and management of patients with HF in primary care.
Original languageEnglish
Article number46
Pages (from-to)A26-A27
Number of pages1
JournalHeart
Volume101
Issue numberSuppl 4
DOIs
Publication statusPublished - 6 Jun 2015
Externally publishedYes
EventBCS annual conference, ‘Hearts and Genes’ - Manchester, United Kingdom
Duration: 8 Jun 201510 Jun 2015

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Heart Failure
Blood Pressure
Health Services Research
Angiotensin-Converting Enzyme Inhibitors
Health Services
Primary Health Care
Guidelines
Hypertension

Cite this

Burey, Lorraine ; Lewthwaite, Kieley ; Terry, Dan ; Lacey, Sam ; Rothwell, Katy ; Humphreys, John ; Adams, Jack ; O'donnell, Caroline ; Cook, Penny A ; Deaton, Christi M. ; Astin, Felicity. / The Development and Evaluation of the Greater Manchester Heart Failure Investigation Tool (GM-HFIT) : A Catalyst for Service Improvement. In: Heart. 2015 ; Vol. 101, No. Suppl 4. pp. A26-A27.
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title = "The Development and Evaluation of the Greater Manchester Heart Failure Investigation Tool (GM-HFIT): A Catalyst for Service Improvement",
abstract = "Introduction Heart failure (HF) is a complex and highly debilitating clinical syndrome. Clear guidelines identify the optimum management of patients living with HF in primary settings but implementation of these is suboptimal.Aim The aim of this service improvement project was to develop a tool kit, The Greater Manchester Heart Failure Investigation Tool (GM-HFIT), to improve the ongoing management of people diagnosed with HF.Methods The GM-HFIT development was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. A prospective, pre-test, post-test design informed an audit conducted between 13th February 2012 and 12th December 2013 with data from two clinical commissioning groups (CCGs) across North West Manchester.Results Data from 1146 matched cases were analysed using McNemar tests (SPSS v20). Preliminary analysis suggests that at baseline, 22{\%} of patients were not eligible to be on the HF register, which decreased to 15{\%} after introduction of the tool (P < 0.001). The recording of blood pressure (BP) was high at both time points (95{\%}), while the recording of pulse and rhythm improved from 58{\%} to 64{\%} and 44{\%} to 49{\%} respectively (P = 0.005). While control of BP remained the same (with 62{\%} of patients with target BP <130/70), the proportion of patients receiving the target dose of ACE Inhibitors and beta blockers improved significantly (70{\%} to 85{\%} and 68{\%} to 85{\%} respectively, P < 0.001). In addition 578 missing patients were added to the heart failure register as a result of the case finding element of the project and a further 6 were recommended for further investigation before adding.Conclusion The GM-HFIT service improvment project led to improvements in identification and management of patients with HF in primary care.",
author = "Lorraine Burey and Kieley Lewthwaite and Dan Terry and Sam Lacey and Katy Rothwell and John Humphreys and Jack Adams and Caroline O'donnell and Cook, {Penny A} and Deaton, {Christi M.} and Felicity Astin",
year = "2015",
month = "6",
day = "6",
doi = "10.1136/heartjnl-2015-308066.46",
language = "English",
volume = "101",
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Burey, L, Lewthwaite, K, Terry, D, Lacey, S, Rothwell, K, Humphreys, J, Adams, J, O'donnell, C, Cook, PA, Deaton, CM & Astin, F 2015, 'The Development and Evaluation of the Greater Manchester Heart Failure Investigation Tool (GM-HFIT): A Catalyst for Service Improvement', Heart, vol. 101, no. Suppl 4, 46, pp. A26-A27. https://doi.org/10.1136/heartjnl-2015-308066.46

The Development and Evaluation of the Greater Manchester Heart Failure Investigation Tool (GM-HFIT) : A Catalyst for Service Improvement. / Burey, Lorraine; Lewthwaite, Kieley; Terry, Dan; Lacey, Sam; Rothwell, Katy; Humphreys, John; Adams, Jack; O'donnell, Caroline; Cook, Penny A; Deaton, Christi M.; Astin, Felicity.

In: Heart, Vol. 101, No. Suppl 4, 46, 06.06.2015, p. A26-A27.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - The Development and Evaluation of the Greater Manchester Heart Failure Investigation Tool (GM-HFIT)

T2 - A Catalyst for Service Improvement

AU - Burey, Lorraine

AU - Lewthwaite, Kieley

AU - Terry, Dan

AU - Lacey, Sam

AU - Rothwell, Katy

AU - Humphreys, John

AU - Adams, Jack

AU - O'donnell, Caroline

AU - Cook, Penny A

AU - Deaton, Christi M.

AU - Astin, Felicity

PY - 2015/6/6

Y1 - 2015/6/6

N2 - Introduction Heart failure (HF) is a complex and highly debilitating clinical syndrome. Clear guidelines identify the optimum management of patients living with HF in primary settings but implementation of these is suboptimal.Aim The aim of this service improvement project was to develop a tool kit, The Greater Manchester Heart Failure Investigation Tool (GM-HFIT), to improve the ongoing management of people diagnosed with HF.Methods The GM-HFIT development was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. A prospective, pre-test, post-test design informed an audit conducted between 13th February 2012 and 12th December 2013 with data from two clinical commissioning groups (CCGs) across North West Manchester.Results Data from 1146 matched cases were analysed using McNemar tests (SPSS v20). Preliminary analysis suggests that at baseline, 22% of patients were not eligible to be on the HF register, which decreased to 15% after introduction of the tool (P < 0.001). The recording of blood pressure (BP) was high at both time points (95%), while the recording of pulse and rhythm improved from 58% to 64% and 44% to 49% respectively (P = 0.005). While control of BP remained the same (with 62% of patients with target BP <130/70), the proportion of patients receiving the target dose of ACE Inhibitors and beta blockers improved significantly (70% to 85% and 68% to 85% respectively, P < 0.001). In addition 578 missing patients were added to the heart failure register as a result of the case finding element of the project and a further 6 were recommended for further investigation before adding.Conclusion The GM-HFIT service improvment project led to improvements in identification and management of patients with HF in primary care.

AB - Introduction Heart failure (HF) is a complex and highly debilitating clinical syndrome. Clear guidelines identify the optimum management of patients living with HF in primary settings but implementation of these is suboptimal.Aim The aim of this service improvement project was to develop a tool kit, The Greater Manchester Heart Failure Investigation Tool (GM-HFIT), to improve the ongoing management of people diagnosed with HF.Methods The GM-HFIT development was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. A prospective, pre-test, post-test design informed an audit conducted between 13th February 2012 and 12th December 2013 with data from two clinical commissioning groups (CCGs) across North West Manchester.Results Data from 1146 matched cases were analysed using McNemar tests (SPSS v20). Preliminary analysis suggests that at baseline, 22% of patients were not eligible to be on the HF register, which decreased to 15% after introduction of the tool (P < 0.001). The recording of blood pressure (BP) was high at both time points (95%), while the recording of pulse and rhythm improved from 58% to 64% and 44% to 49% respectively (P = 0.005). While control of BP remained the same (with 62% of patients with target BP <130/70), the proportion of patients receiving the target dose of ACE Inhibitors and beta blockers improved significantly (70% to 85% and 68% to 85% respectively, P < 0.001). In addition 578 missing patients were added to the heart failure register as a result of the case finding element of the project and a further 6 were recommended for further investigation before adding.Conclusion The GM-HFIT service improvment project led to improvements in identification and management of patients with HF in primary care.

U2 - 10.1136/heartjnl-2015-308066.46

DO - 10.1136/heartjnl-2015-308066.46

M3 - Meeting Abstract

VL - 101

SP - A26-A27

JO - Heart

JF - Heart

SN - 1355-6037

IS - Suppl 4

M1 - 46

ER -