Table 1

Institute of Medicine’s six-aim STEEEP model

SafeGuideline-directed medical therapy has been proven to have greater benefit to overall mortality and quality of life in patients with HF in comparison to risks of adverse effects
TimelyIdentification of eligible patients due for echocardiogram and initial medication reconciliation performed during physicians’ administrative task time; and recheck at the time of the clinic visit leading to timely completion of the patient visit; monthly tracking of echocardiogram completion and HF classification rates
EffectiveGuideline-directed medical therapy for systolic HF has been proven to improve ejection fraction and mortality.
EfficientPrescribing guideline-directed medical therapy for patients with HF may lead to reduction in emergency department visits and hospital readmission rates.
EquitableIntent to provide guideline-directed medical therapy to all patients and to provide certain medication classes over others based on ethnicity, such as use of ACE or angiotensin receptor blockers in Caucasians, and hydralazine and nitrates in African–Americans
Patient-centredUltimate aim is to improve patient mortality and quality of life with patient engagement and shared decision making
  • HF, heart failure; STEEEP, safe, timely, effective, efficient, equitable and patient-centred.