Improving Heart Failure Quality of Care Over the First Twenty Years: The Get With The Guidelines-Heart Failure Program

BACKGROUND: The Get With The Guidelines-Heart Failure program is a national quality improvement initiative that was established in 2005 with the goal of improving the quality of care for patients hospitalized with heart failure. METHODS: We examined patient characteristics, adherence to achievement and quality measures, and in-hospital outcomes in patients hospitalized with heart failure among Get With The Guidelines-Heart Failure fully participating hospitals between 2005 and 2024. Measures were applied to eligible patients without documented contraindications. Multivariable regression analysis, adjusting for patient and hospital characteristics, was performed to assess temporal changes in individual measures and outcomes. RESULTS: Over the first 20 years, the Get With The Guidelines-Heart Failure program has grown to include 1 561 093 patient records (median age 73 [62–83], 47.4% women, median ejection fraction 45% [28%–58%]) and 819 participating hospitals. There was significant and sustained improvement in an all-or-none composite achievement metric, with an increase from 76.1% to 88.7% between 2005 and 2024 (adjusted odds ratio, 3.7 [95% CI, 3.5–4.0]; P