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Peer-reviewedCC BY-NC-ND 4.0JACC Case Reports

Beyond Detection

  • Benjamin M. Easow1
  • Tijin Mathew1
  • Devesh Dahale2
  • Darius Aliabadi3
  1. 1Internal Medicine Residency Program, Southeast Health, Dothan, Alabama, USA
  2. 2Health System Engineering, Southeast Health, Dothan, Alabama, USA
  3. 3Interventional Cardiologist, Department of Cardiology, Southeast Health, Dothan, Alabama, USA
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Abstract

Background: Iron deficiency is a common comorbidity among patients with heart failure with reduced ejection fraction (HFrEF), and it remains under-recognized and undertreated despite contemporary guideline recommendations for intravenous iron therapy.

Project Rationale: We sought to increase iron deficiency screening among hospitalized patients with HFrEF from a baseline of approximately 12% to >50% while identifying barriers to implementation of guideline-directed intravenous iron therapy.

Project Summary: A multiphase Plan-Do-Study-Act quality improvement initiative integrated an iron panel into the heart failure admission order set, provided targeted provider education, and subsequently developed a standardized intravenous iron replacement protocol for integration into the electronic health record. Among 441 hospitalized patients with HFrEF, screening increased to 64.6% (285/441). Iron deficiency was identified in 243 of 285 screened patients (85.3%), yet only 67 (27.6%) received intravenous iron therapy.

Take-Home Messages: Improving screening alone is insufficient to optimize iron deficiency care in hospitalized patients with HFrEF. Closing the gap between diagnosis and treatment will require workflow-integrated strategies to facilitate implementation of guideline-directed intravenous iron therapy.

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Cite

BibTeXRIS
BibTeX
@article{easow2026beyond,
  title = {{Beyond Detection}},
  author = {Benjamin M. Easow and Tijin Mathew and Devesh Dahale and Darius Aliabadi},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109659},
  url = {https://doi.org/10.1016/j.jaccas.2026.109659},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Beyond Detection
AU  - Benjamin M. Easow
AU  - Tijin Mathew
AU  - Devesh Dahale
AU  - Darius Aliabadi
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109659
UR  - https://doi.org/10.1016/j.jaccas.2026.109659
AB  - Background: Iron deficiency is a common comorbidity among patients with heart failure with reduced ejection fraction (HFrEF), and it remains under-recognized and undertreated despite contemporary guideline recommendations for intravenous iron therapy.  Project Rationale: We sought to increase iron deficiency screening among hospitalized patients with HFrEF from a baseline of approximately 12% to >50% while identifying barriers to implementation of guideline-directed intravenous iron therapy.  Project Summary: A multiphase Plan-Do-Study-Act quality improvement initiative integrated an iron panel into the heart failure admission order set, provided targeted provider education, and subsequently developed a standardized intravenous iron replacement protocol for integration into the electronic health record. Among 441 hospitalized patients with HFrEF, screening increased to 64.6% (285/441). Iron deficiency was identified in 243 of 285 screened patients (85.3%), yet only 67 (27.6%) received intravenous iron therapy.  Take-Home Messages: Improving screening alone is insufficient to optimize iron deficiency care in hospitalized patients with HFrEF. Closing the gap between diagnosis and treatment will require workflow-integrated strategies to facilitate implementation of guideline-directed intravenous iron therapy.
SN  - 2666-0849
ER  -