Document Type

Final Project

Graduation Date

Winter 12-16-2022

Degree Name

Doctor of Nursing Practice

First Advisor

Bunny Pozehl

Second Advisor

Windy Alonso

Abstract

Background The HF-Optimize clinic showed improved utilization of guideline-directed medical therapy (GDMT) along with improved clinical outcomes from 2018 to 2020. Appointment compliance was poor with only 44% of patients completing all HF-Optimize visits. Missed appointments led to worse health outcomes, fragmented care, and provider inefficiencies. Interventions to improve appointment compliance are vital to improving heart failure outcomes. Objective The purpose of this quality improvement project is to evaluate the impact that an enhanced enrollment process has on appointment compliance in a culturally diverse, adult population referred to the HF-Optimize clinic at Nebraska Medicine. Methods This prospective quality improvement project evaluated an enhanced enrollment process for patients scheduled for their first visit to the HF-Optimize clinic between March 1, 2022, and August 31, 2022. The enhanced enrollment process included tracking reasons for missed appointments, deployment of an educational video, and instructing patients to enroll in MyChart. Evaluation of the enhanced enrollment process included a survey assessing if the patient watched the video, if they found the video helpful, and if it contributed to them coming to their first appointment. Demographics and MyChart enrollment were collected. Results A total of 138 patients were referred to the HF-Optimize clinic between March 1, 2022 and August 31, 2022. Patients were a mean age of 60.9 +/- 3.5 years, 42% female, and 33% non

white. Of those referred, 98 patients came to their first appointment (71%). There were 59 video surveys completed. There were 50 patients that reported signing up for MyChart (85%). There were 15 patients that reported watching the HF-Optimize video. The majority of patients (59%) rated the video between 8 to 10 for helpfulness. Conclusions Appointment compliance improved during the project period. Patients completing the video survey found it to be helpful in describing the HF-Optimize clinic. Due to the small number of completed surveys, a relationship between video viewing and appointment compliance could not be determined. Future studies should utilize electronic applications that track individual use. Keywords: Heart Failure, Optimize, appointment compliance

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