Happy Hearts Automatic Referral (HHAR) was a program that referred heart failure (HF) patients to Transitional Care (TC) at Banner Health. The purpose of the human subject’s research was to examine the use of the Minnesota Living with Heart Failure® questionnaire (MLHFQ) as a survey instrument to identify moderate quality of life (QOL) in patients living with HF. The most common referral to TC prior to the project was patients with poor QOL. The project explored the influence of earlier referrals to improve QOL for participants living with HF. The MLHFQ was chosen because it is a valid and reliable instrument specific to QOL. The HF population was chosen because the most commonly referred patients to interventions such as TC are those that pose the smallest risk for readmission, have the highest risk of readmission, or have the potential to demonstrate the most significant increase in QOL. By offering TC to patients with moderate QOL, an opportunity existed to reduce advancement into a population that is characteristic of high-risk readmissions. The project identified potential participants, then administered the MLHFQ, and scored it. When scores were between 26 and 45, participants were considered qualified participants for this project. Ideally, the patient would have been enrolled in TC for 30 days and the project would have administered another MLHFQ at completion of 30 days of TC to evaluate a change in QOL; however, due to the short-term nature of this project the TC content and follow-up administration of the MLHFQ was not evaluated. Also, while this project was taking place the TC team at Banner Health was not accepting new patients. A human subject’s research approach was applied and examined the responses to the MLHFQ from a small sample of five moderate QOL participants and described the expected responses for improved QOL if a second MLHFQ was to be administered following TC. Specifically items 1, 7, 8, 14, and 19 were examined to discuss how TC interventions might have improved scores on these items. The project concluded by describing how future cycles should be completed for further research.

Congestive heart failure (CHF) affects an estimated 5.1 million Americans over the age of 20. The purpose of this quantitative study was to determine whether there is a difference in the Quality of Life (QOL) for Congestive heart failure patients receiving care through telehealth compared to patients receiving face-to-face care (usual care). Guiding this project was the Self-Care Model of Chronic Illness because the primary outcome of the self-care model is illness stability, well-being, and quality of life. Seventy-seven veterans with Heart Failure (HF) from the Washington D.C. Veterans Affairs Medical Center (VAMC) participated in the project. Forty reported they were receiving telehealth and 37 reported that they were receiving face-to-face care. The average participant age was 67 years with a range of 44 to 93 years. Seventy-five of the participants were male and 2 were female. Sixty-four participants were Black and 12 were White. The Minnesota Living with Heart Failure (MLHF) questionnaire average score for the telehealth group was 49.4 (SD = 28.7) and the face-to-face care group was 37 (SD = 27.9). With equal variance assumed, there was no significant difference between MLHF scores in the telehealth group compared to the usual care group (t = -1.91, p > .05). Thus, opportunities for using telehealth without negatively affecting patient outcomes, such as QOL, are plausible. It can be concluded that providing services using home telehealth for HF patients may produce outcomes that are equivalent to those receiving traditional services.

Previous research on quality of life (QOL) and its relation to BNP levels in heart failure (HF) has been widely studied. However, the impact of physicians' knowledge of BNP levels at time of clinic visit on QOL and hospital length of stay (LOS) has yet to be fully investigated. The purpose of this study were to determine if physicians' knowledge of BNP levels affected a change in QOL scores at 90 days and reduce hospital length of stay among heart failure patients. QOL data from HF clinic patients (N = 108, 67.5 ± 12.3, 56% male, ejection fraction 26.5 ± 8.2) were analyzed. QOL was measured at time of clinic visit (T1) and at 90 days (T2) using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). An independent t-test was utilized to compare the two groups. Findings: Both groups were comparable regarding demographic and baseline characteristics. There was no significant association observed between the experimental and control group at 90 days, although the data indicated a decrease in the mean QOL scores at 90 days (37.46 ± 28.67) as compared to the mean QOL scores at baseline (46.87 ± 29.63) for both groups. Because the QOL scale is reversed, this indicated that there was a positive change in QOL scores during the 90 day time interval. Hospital LOS was similar for both groups (mean=3 days). BNP levels were significantly correlated with both baseline QOL scores (r=.25, p=.01) and physical subscale scores (r=.24, p=.01). Mortality was higher in the control when compared to the experimental group (t=1.99, df=90, p=.04). Conclusion: While physicians' awareness of BNP levels had not shown a significant change in QOL at 90 days, patients' QOL might already have been quite positive. Chronic HF patients may have adapted to their disease and have adjusted their perception of their QOL. Therefore, QOL may be a stable construct at this time. Findings may have been different on newly diagnosed HF patients since they may not have adapted to their health condition.