Congestive Heart Failure

Quality Initiatives

SRHS History of CHF Focus

• Team early 90’s, developed Care Map, adopted education materials and guidelines

• Team mid 90’s, wrote Duke Endowment and SRHS Foundation grant applications….started CHF Clinic

• 2001-CHF Health Management Specialist added, expanded Tele-Services CHF Program

• 2003-SRHS Foundation continues to support the program, CHF Clinic continues, CHF Team restructured

• 2004-CHF Clinic becomes Heart Failure Center- adds Outpatient Natrecor

CHF CORE Team

• Cardiologist• Executive Director Heart Center• VP Patient Care Services – Heart Center• Director Health Management• Nurse Practitioners- Heart Failure Center• Cardiology Clinical Outcomes Specialist• PharmD• CHF Case Manager• ED Physician

Quality Indicators

• HF CORE / Seventh Scope of Work• LOS• Readmit Rate• Mortality Rate• Physician Practice Specific Data- Severity

Adjusted– LOS– Cost/Case– Readmit Rate– Mortality Rate

Improvement Tools

Name ________ Date _______Name ________ Date _______

Freshstart Smoking Cessation Freshstart Smoking Cessation ClassClass

For more information and registration For more information and registration

call toll freecall toll free

1-877-455-77471-877-455-7747

______________________________________

…….... Your Healthcare ProfessionalYour Healthcare Professional

Smoking Cessation Prescription

Smoking Cessation Advice/Counseling

•Incorporated into Care Manager Documentation System

•Incorporated into WITT Hemodynamic System (Cardiac Cath Lab)

•Provide Patient/Family with Smoking Cessation Prescription (Nursing Units, Cardiac Cath Lab, HF Center, Cardiac Rehab

Improvement Tools

CHECKLIST FOR CARDIOVASCULAR DISEASE

(ACS/ MI/ CHF/ CABG)

YES CONTRA-INDICATED

N / A

1)ASA

2)BETA BLOCKER

EJECTION FRACTION: _______________

3)ACE-I FOR LVEF LESS THAN 40

4)ARB

5)LIPID PROFILE CHECKED

6)STATIN’S OR OTHER LIPID LOWERING DRUGS

7)SMOKING CESSATION

8)DIET/ EXERCISE

(CARDIAC REHAB)

More Tools

• HF Order Set

• HF Care Sequence

• Nursing PI Team –(Patient & Staff Education)

• ED Algorithms

• Medical Staff Peer Review

To Continue to Improve

• Provide consistency by following Standard of Care

• Patient & Family education during hospitalization

• Referrals to CHF Case Manager

• Referrals to Heart Failure Center

• Referrals to Tele-Services

• Referrals to Home Health/Hospice