Aurora St. Luke's Medical Center


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Aurora St. Luke's Medical Center

  1. 1. Aurora Health Care Aurora St. Luke’s Medical Center Milwaukee, WI. Get With the Guidelines Presentation August 29, 2007 Natalie Singer RN
  2. 2. Background St. Luke’s Medical Center Aurora Health Care <ul><li>System </li></ul><ul><li>14 Hospitals in System </li></ul><ul><li>80 clinics </li></ul><ul><li>130 Pharmacies </li></ul><ul><li>SLMC- Tertiary Access Center </li></ul><ul><li>Licensed for 938 beds </li></ul><ul><li>Submit data to: Premier, CMS, GWTG-HF, Stroke & CAD , STS and ACC-NCDR </li></ul><ul><li>Many physicians are private practice </li></ul><ul><li>Cardiology Resident program </li></ul>
  3. 3. GWTG background for ASLMC <ul><li>Submitting to Get With the Guidelines: HF since March, 2006 & CAD since 2003 </li></ul><ul><ul><li>CAD: Summary Tool </li></ul></ul><ul><ul><li>HF: Average 70-80 patients per month – over 1,000 patients submitted to date </li></ul></ul>
  4. 4. Using the GWTG Reporting System <ul><li>Submit all patients through web-based tool </li></ul><ul><li>Ongoing running of reports through web-based reporting system –up to date reporting </li></ul><ul><ul><li>The Composite Performance Measure gives us an overall sense of performance – have to be doing well in all measures to have good scores. </li></ul></ul><ul><ul><li>HF Defect-Free Care Measure allows us to see that we are providing best care/interventions on all required measures for all eligible patients. </li></ul></ul><ul><ul><li>The reports also help us drill down on individual measures, evaluate clinical practice patterns and track patient outcomes. </li></ul></ul><ul><ul><li>Can benchmark to “like facilities” and National levels </li></ul></ul><ul><ul><li>Allows for baseline data and measuring of process improvements </li></ul></ul>
  5. 5. Using the Reports from GWTG <ul><li>Reports reviewed with the Director and Cardiac Program Manager to evaluate our cardiac program which has led to the following: </li></ul><ul><li>Developed HF specific team within our facility to focus on the measures and work towards implementing “best practice”. </li></ul><ul><li>Heart Failure Coordinators: two RNs who see inpatients with diagnosis of HF to ensure that all of the measures have been met and documented prior to discharge. </li></ul><ul><li>Identify barriers to measures we could improve on and help to strategize new approaches to care. </li></ul>
  6. 6. Barriers <ul><li>Example of Issue: </li></ul><ul><li>Physicians not documenting EF for patients with LVSD & lack of contraindications documented when not prescribing ACE or ARB medications. </li></ul><ul><li>Action to Correct: </li></ul><ul><li>Development of Standardized Heart Failure order sets. </li></ul><ul><li>Heart Failure Coordinators monitor usage of orders, check documentation and follow up with physicians and nursing. </li></ul><ul><li>Physician report cards provided by QM to show areas of success and deficits. </li></ul>
  7. 7. Outcome <ul><li>We saw an increase in our measure of LV documentation and better documentation of contraindications. </li></ul><ul><li>This led to an overall increase in those measures and gave us better Composite Performance and Defect-free measures. </li></ul><ul><li>Documentation and care has changed and has led to better HF pt management. </li></ul>
  8. 8. Additional Reporting Options <ul><li>Benefits of participating in Get With the Guidelines </li></ul><ul><li>Met our Initial Achievement Performance Award </li></ul><ul><li>Met our Annual Performance Achievement Award </li></ul><ul><li>Evidence per reporting that we are providing “best practice” and “defect-free” care to our heart failure patients. </li></ul>
  9. 9. Final Thoughts Through participating in Get with the Guidelines, we have been able to identify areas of success, needs for improvement and able to measure our outcomes through the data reporting made available to us. We can see, not only individual measures, but track overall composite performance and defect-free care over time to ensure we are providing the best care and helping to “save more lives”. There is a wide variety of resources available through the website as well as patient specific information when entering into the web-based tool.
  10. 10. Thank You!!