In-hospital heart failure (HF) quality improvement interventions varied across trials, 5 tested interventions that included various combinations of HF specific patient education, HF guideline clinical staff education, admission order sets, in-hospital guideline-recommended medication reminders, discharge checklists, case management coordination of care, performance reports and postdischarge telephone calls. Interventions in 5 trials emphasised HF specific patient education on medication management including self-management of diuretics, maintaining a symptom diary, diet and tobacco and alcohol cessation. Two large RCTs evaluated the specific effect of audit and feedback by sharing personalised quality improvement reports highlighting performance measures to each hospital site or via a publicly released report card. Two studies evaluated the effect of automated guideline-recommended medication reminders attached to echocardiography reports.