DeVore AD, Granger BB, Fonarow GC, et al. - For patients with heart failure with reduced ejection fraction, a hospital and postdischarge quality improvement intervention did not result in improved clinical outcomes or measures of care quality.

• A total of 161 hospitals in the United States participated in this cluster-randomized clinical trial.

• Vital status was known for 5,636 (99.8%) of the 5,647 patients (mean age, 63 years; 33% women; 38% Black; 87% chronic heart failure; 49% recent heart failure hospitalization).

• Rehospitalization for heart failure or all-cause mortality occurred in 38.6% in the intervention group vs 39.2% in usual care (adjusted hazard ratio, 0.92 [95% CI, 0.81 to 1.05).

• The baseline quality-of-care score was 42.1% vs 45.5%, and the change from baseline to follow-up was 2.3% vs −1.0%, with no significant variation in the probabilities of reaching a better composite quality score at the last follow-up between the two groups.