The Institute is committed to a vision that Kansas City can deliver the nation’s highest value, most equitable healthcare. We design, implement and evaluate healthcare delivery interventions to improve the quality and value of healthcare throughout the region by catalyzing and facilitating multi-stakeholder collaborations. Following is a brief overview of Institute projects and accomplishments this year:
Innovations in Healthcare Delivery:
- Transitions of Care for Heart Failure.
Transitioning from hospital to home can be a very challenging process and particularly so for patients with heart failure, one of the conditions with the highest proportion of patients returning to the hospital within a month of discharge. The Institute has partnered with hospitals, payers, and community-based organizations to offer 3 ongoing interventions to improve transitions in patient care and ultimately, reduce readmission rates:
- CODE HF. Patients with heart failure who have worsening shortness of breath often present repeatedly to the Emergency Department (ED). CodeHF is a regional Quality Improvement (QI) project implementing a care pathway to support the rapid diagnosis and treatment of such individuals, supported by prospective risk stratification to identify which patients can be safely discharged home with early cardiology follow-up. The Institute supports sites implementing the pathway by educating team members on its use and working with them to measure its safety and impact. The program was
piloted at Saint Luke’s Health System and has been activated at the University of Kansas Medical Center (KU) where they have had a remarkably engaged clinical staff (both ED and Cardiology) and ongoing work to monitor and measure impact. Two other regional sites are actively evaluating a launch of the program. - Community Support Network (CSN). Patients with barriers to care, such as transportation, food insecurity and other social determinants of health (SDoH), are particularly vulnerable. In partnership with the Mid-America Regional Council (MARC), the Institute has been working with clinical sites (Saint Luke’s Hospital, University Health, Advent Health, and Centerpoint/HCA, to date) to support patients with heart failure and SDoH needs. The CSN initiative provides access to 90 days of wraparound services, including an in-home evaluation of needs for home-delivered meals, medication reconciliation, transportation assistance, or other social services. The CSN, a hub and spoke model, where MARC is the hub contracting needed services to ensure timely responses to patients’ social needs shortly after discharge from the hospital, is unique to the region. As of November 2025, the CSN has screened 2,716 patients for the program, with 1,522 being eligible, and 193 referred. This space between being eligible and referred is a large part of the Institute’s work towards helping to understand challenges and gaps in care throughout the Kansas City region. A formal evaluation of the program’s success will be conducted in 2026.
- IMPLEMENT-HF. The Institute partnered with the American Heart Association (AHA) on the IMPLEMENT-HF initiative, aimed at improving guideline-directed medial therapy (GDMT) and outcomes for patients with heart failure. The initiative involved 7 metro regions across the U.S., including Kansas City. The IMPLEMENT-HF initiative has been completed and it demonstrated substantial improvements in the uptake of optimal, 4-drug GDMT at discharge; from 14% to 49% within two years. Dr. Andrew Sauer, a Kansas City-based cardiologist, presented on the findings and was first author on publications disseminating findings. Heart failure physician, Dr. Steve Dickson, also Kansas City-based, recently presented to the 2025 American Heart Association’s Scientific Sessions on his 4-drug/4-week strategy for optimizing outcomes.
- CODE HF. Patients with heart failure who have worsening shortness of breath often present repeatedly to the Emergency Department (ED). CodeHF is a regional Quality Improvement (QI) project implementing a care pathway to support the rapid diagnosis and treatment of such individuals, supported by prospective risk stratification to identify which patients can be safely discharged home with early cardiology follow-up. The Institute supports sites implementing the pathway by educating team members on its use and working with them to measure its safety and impact. The program was
- Opioid Initiative. When the work of the Institute was constituted in 2017, the opioid epidemic was a primary concern for providers and health systems. At that time, the Missouri Hospital Association was launching the Western Region – Engaging Patients in Care Coordination (WR-EPICC) program to support patients in the throes of an opioid crisis. The Institute partnered with the Missouri Hospital Association and CommCare to conduct a qualitative and quantitative evaluation of the EPICC program. The team has presented results at AcademyHealth and American Academy of Addiction Psychiatry (AAAP) and is preparing reports for publication and dissemination.
- Maternal Health. In 2024, the Institute began to assess an area of increasing crises and priority in the healthcare field, maternal health. Guided by a powerhouse, multi-disciplinary Advisory body, the greatest opportunity to improve care and outcomes was identified to be through improvements in the management of hypertension disorders of pregnancy (HDoP). The Institute’s initial efforts will have special emphasis on patients who present to the region’s EDs. For this unique focus and effort, the Institute was recognized with a $50,000 grant from the 2025 Blue Cross Blue Shield of Kansas City/BioNexus KC competition. We value all efforts to maximize positive impacts and outcomes on maternal health, and we seek to align, synergize and support the maternal health strategies of other regional leaders in this work including those of the Kansas City Health Department, the Kansas City Healthcare Collaborative, Missouri and Kansas Hospital Associations, the Health Forward Foundation and others.
Building a Learning Healthcare Community:
- TIARA. Changing clinical practice is very difficult and is a key focus of the emerging discipline of implementation science. Despite years of education, healthcare practitioners are not trained in implementation science strategies. To meet this gap in training, the Institute developed TIARA; Training in Implementation: Actionable Research Approaches, certificate program. TIARA is a condensed but rich ‘cliff notes’ in implementation science. Beyond the annual synchronous training offered each January-May through UMKC, TIARA’s influence is expanding quickly! In July 2025, TIARA was presented to ~100 attendees in Adelaide, Australia, to rave reviews. Scientific Societies have also requested TIARA be presented at their convenings. Scan or click on the QR code to register for the 2026 session here in Kansas City!
- IQ Forums. Bi-monthly Innovations in Quality Forums (IQ Forums) are designed to enrich professionals at every level of the healthcare field through engaging and timely topic exploration with subject-matter-experts, and audience discussion. In 2025, IQ Forums had 305 registrants from 117 institutions, agencies and departments. Topics covered evolutions in the health insurance industry, AI in healthcare, public health, drug costs, and community health workers. The 2026 IQ Forum schedule, curated by a listserv of 700+ is live! There is no cost to attend an IQ Forum. Participation is delivered hybridly, in person at the Kauffman Foundation Conference Center or via Zoom. If you know someone who should be added to our IQ Forum listserv, email macdonaldp@umkc.edu.
Oh, But There is More!
The Institute is grateful for invitations and grant support that allow us to bring our expertise to external regional and national projects:
- HOPE (Heart Outcomes in Pregnancy Expectations) Study: Aligned with our regional maternal health initiative, the Institute is leading the first, and largest, U.S. study on the care and outcomes of pregnant women with heart disease. While comprising only 1-3% of pregnancies, pre-existing heart disease is present in over one-third of maternal deaths. HOPE will enroll 1,000 patients from 35 U.S. health centers to provide the first U.S. evidence on the risks and optimal treatment strategies for these women. HOPE has entered its second of four years of funding and has already enrolled 410 participants.
- RECHARGE (Revascularization Choices Among Under-Represented Groups): Patients with severe coronary artery disease often face a choice of being treated with stents or bypass surgery. While there have been numerous clinical trials comparing these treatment strategies, only 20% of trial participants have been women and only 8% have been Black. This creates a huge evidence gap that precludes physicians from knowing how best to treat them. To address this knowledge gap, RECHARGE will randomize only women, and Black, and Hispanic patients, in a 1600-participant trial, and study their long-term survival and quality of life outcomes. After a successful feasibility phase where the Institute contributed to the design and implementation of the study, including conducting all of the feasibility phase’s patient follow up, in 2025, PCORI funded the trial’s advancement to full phase.
- ROMA: Women (Randomized comparison of the Outcomes of single vs. Multi-Arterial grafts in Women): Like RECHARGE, very little evidence guides how best to perform bypass surgery in women. This NIH-funded study will randomize women to different revascularization techniques to understand with greater clarity how to more effectively treat women with advanced coronary artery disease.
- Quality of Life in Patients with Tricuspid Valve Disease: New treatments are emerging for patients with leaky right-sided heart valves. The FDA reached out to the Institute to help define how best to measure these patients’ quality of life. This 3-year contract concluded in 2025 and produced several publications and multiple scientific presentations to help inform future clinical trials.
- Frontiers CTSI (Clinical and Translational Science Institute): The Institute continues to be actively engaged in our region’s NIH/NCATS CTSI led by the University of Kansas with these key partnerships: Children’s Mercy Hospital, Kansas City University, Saint Luke’s Health System, and Kansas State University.
Thank you for your friendship and support of the Healthcare Institute for Innovations in Quality’s vision for a high-value and just healthcare system for Kansas City!