Using Video Education to Improve Outcomes in Heart Failure (VETiO-HF)

Background: Heart Failure (HF) education is a national quality measure of HF care. The optimal method of educating HF patients is not known but video education (VE) can provide a standardized method to teach HF patients, and was recommended by the 2010 Heart Failure Society of America guidelines. VE delivery via mobile technology can be an efficient and convenient way to deliver HF education as patients transition from hospital to home.

Purpose: This quality improvement project evaluated the effectiveness of supplementing usual HF patient education with VE in improving knowledge of HF, self-efficacy, self-care and reducing 30-day readmissions as well as assessed patients’ satisfaction with VE.

Methods: A project using a pre-test/post-test design and convenience sampling was conducted over 11 weeks at an academic medical center in Virginia. Demographic and clinical data were collected via chart reviews and patient interviews. Participants completed the Atlanta Heart Failure Knowledge Test and the Self-care of Heart Failure Index before and after receiving VE, to measure HF knowledge, self-efficacy and self-care respectively. A video usage log and satisfaction questionnaire was completed. VE was accessed via a computer, smartphone, personal or loaned tablet computer. Participants received a “Managing Your Heart Failure With Video Education” booklet to aid accessing the videos. Seventy participants enrolled and 30 completed the study. All-cause 30-day readmission data was compared to a randomly selected historical group (September, 2016 – November, 2016) within the same hospital.

Results: Participant’s HF knowledge and self-maintenance scores increased significantly (mean 1.70, SD 3.2, p =.008, mean 13.96, SD 20.99, p =.001 respectively). HF knowledge scores improved by at least 5% on 20 of the 30 questions across all domains assessed. Self-efficacy (self-care confidence) and self-care management did not significantly improve (mean 1.67, SD 26.69, p = .735; mean 9.43, SD 22.79, p =.073 respectively). All-cause 30-day hospital readmissions did not significantly decrease (9/ 30% to 7/ 23.3%, p= .276). HF patients were satisfied with the VE information (96.2%) and all would recommend the videos (100%). The videos rated most helpful were: Heart Failure Medications: Diuretics (71.4%) and Managing Heart Failure: Limiting Sodium (65%).

Conclusion: Supplementing usual HF education with VE significantly improved HF knowledge and self-maintenance with high patient satisfaction. Evaluating the impact of using VE provides useful information that may influence future patient education efforts and improve HF outcomes. HF knowledge scores may be further used to tailor patient education based on identified knowledge gaps. Future research is needed to investigate whether self-efficacy and self-management improves with continued follow-up.

Practice Implications: In collaboration with the patient education officer, the videos were aligned to HF teaching topics in the electronic medical record system (Epic) for future health system-wide use, enabling nurses to easily access and provide HF teaching as well as supports the health system in meeting national requirements for HF education. Motivated by the daughter of a patient searching for HF information, the videos were added to the home screen of the Patient and Family Library’s home screen for improved access for patients/ families and staff.