OPTIMIZE HF also provided tools to help hospitals improve the reliability of heart failure care, including standardized admission orders, discharge checklists, pocket cards, medical chart stickers, best-practice algorithms and critical pathways. Researchers found that use of these tools impacted outcomes. In-hospital mortality dropped from 4.1 to 2.5 percent for cases in which hospital staff utilized standard admission orders to help direct treatment. Post-discharge death and re-hospitalization rates decreased from 38.2 to 34.8 percent when tools were utilized during care. Fonarow said that the American Heart Association has adopted OPTIMIZE HF for use in its Get With the Guidelines Heart Failure quality improvement program, in which more than 400 hospitals nationwide are now participating.