CHF Team Quality Report

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St. Anthony\'s CHF Team Quality Initiatives Report

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  • Our multidisciplinary team met monthly for a few years. Currently the leadership of the team (Cardiology, hospitalist and ED physicians, CV Director, and HF coordinator) meet monthly, with the entire team gathering quarterly. Essential to our success has been the active participation of physician champions and unit-based nursing champions
  • Ross JS, Chen J, Lin ZQ, et al. Recent national trends in readmission rates after heart failure hospitalization. Circ Heart Fail 2009; available at: http://circheartfailure.ahajournals.org
  • Composite score for CMS core measures from SAC, SAN and Summit
  • Composite score for CMS core measures from SAC, SAN and Summit
  • CHF Team Quality Report

    1. 2. Nursing Medicine Ancillary <ul><li>CNO </li></ul><ul><li>Nursing Managers </li></ul><ul><ul><li>Tele </li></ul></ul><ul><ul><li>Medicine </li></ul></ul><ul><ul><li>ED </li></ul></ul><ul><li>HF Coordinator </li></ul><ul><li>Cardiac Rehab </li></ul><ul><li>Cardiology </li></ul><ul><li>Hospitalist </li></ul><ul><li>ED </li></ul><ul><li>Case Management </li></ul><ul><li>Quality </li></ul><ul><li>Nutrition Services </li></ul><ul><li>Pharmacy </li></ul><ul><li>Home Health </li></ul><ul><li>Chaplain </li></ul><ul><li>Palliative Care </li></ul>Heart Failure Clinical Effectiveness Team
    2. 3. <ul><li>Most common reason for hospitalization for people 65+ years old </li></ul><ul><li>Most expensive diagnosis for Medicare patients, with >50% of cost associated with hospitalization </li></ul><ul><li>Only CV disease increasing in incidence </li></ul><ul><li>TJC has identified quality indicators for hospitalized HF patients </li></ul>American Heart Association. 2010 Heart and Stroke Statistical Update. Dallas, Tex. * Per year Number of Americans with HF New Cases diagnosed Americans dying of HF Hospital Discharges Cost (Direct + Indirect) 5,800,000 * 670,000 * 282,754 * 1,106,000 * $39.2 billion *
    3. 4. <ul><li>a. a specific characteristic of an object (the qualities of ice - i.e. its properties). </li></ul><ul><li>b. the achievement or excellence of an object (good quality ice - i.e. not of inferior grade). </li></ul><ul><li>c. the essence of an object (the quality of ice - i.e. &quot;iceness&quot;). </li></ul><ul><li>d. the meaning of excellence itself. </li></ul>http://en.wikipedia.org/wiki/Quality, Sept 2006
    4. 5. <ul><li>Inpatient Care </li></ul><ul><li>Apply EBM </li></ul><ul><li>Standardize processes </li></ul><ul><li>Continuous PI </li></ul><ul><li>Core Measures </li></ul>
    5. 7. <ul><li>Focused, resourced effort to promote evidence-based practice has resulted in: </li></ul><ul><ul><li>Improved processes of care for HF patients </li></ul></ul><ul><ul><ul><li>Dramatic increase in core measure adherence </li></ul></ul></ul><ul><ul><li>Stabilization of readmission rate </li></ul></ul><ul><ul><li>Identification of opportunities to expand HF care </li></ul></ul><ul><li>Recognition as a community leader in Heart Failure care </li></ul><ul><ul><li>Advanced Heart Failure Certification from </li></ul></ul><ul><ul><li>The Joint Commission </li></ul></ul><ul><ul><li>Gold recognition from AHA’s Get With The Guidelines </li></ul></ul>2 nd Hospital In the Nation!
    6. 8. 30-day Readmit rate n=359 n=369 n=326 n=258 n=262 n=232 n=88 St. Anthony Central Snapshot (SAC Decision Support) Nat ’ l Avg: 24%
    7. 9. Composite Score (SAC ) (CMS/GWTG) Comprehensive HF Instructions LV Function Documented ACE/ARB @ DC for LVF <40% Smoking Cessation Advice BB @ DC for LVF <40%
    8. 10. HF Coordinator Hired Med-Rec tackled GWTG Data (5-measure composite)
    9. 11. <ul><li>HealthGrades Gap Analysis </li></ul><ul><li>Improving Discharge Medication Reconciliation process </li></ul><ul><li>Improving Consent and Time-Out processes </li></ul><ul><li>Exploring options for extending services to patients after discharge </li></ul>
    10. 12. Composite Score (SAC ) (CMS/GWTG) Comprehensive HF Instructions LV Function Documented ACE/ARB @ DC for LVF <40% Smoking Cessation Advice BB @ DC for LVF <40%
    11. 13. <ul><li>Quality is the fundamental force in the universe, stimulating everything from atoms to animals to evolve and incorporate ever greater levels of Quality. </li></ul><ul><li>According to the MOQ, everything (including mind, ideas and matter) is a product and a result of Quality. </li></ul>Zen and the Art of Motorcycle Maintenance and Lila: An Inquiry into Morals by Robert Pirsig.
    12. 14. October by Tony Abeyta
    13. 15. Get With The Guidelines data (2006-2010) LOS

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