Heart Failure Core Measures GMEC QI Presentation.
-
Upload
roy-stafford -
Category
Documents
-
view
218 -
download
0
Transcript of Heart Failure Core Measures GMEC QI Presentation.
![Page 1: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/1.jpg)
Heart Failure Core Measures
GMEC QI Presentation
![Page 2: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/2.jpg)
Congestive Heart Failure
Heart failure accounts for more than 700,000 hospitalizations every year.
Heart Failure is associated with high rates of mortality and morbidity.
![Page 3: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/3.jpg)
Core Measures
standardized sets of valid, reliable and evidence based measures of care
describe the level of performance with regard to patient outcomes
provide a “comparative” measurement that is standardized and risk adjusted.
Core Measures drive the CMS Quality Initiatives (i.e., pay for performance)
![Page 4: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/4.jpg)
CHF Core Measures Team
Multidisciplinary:o Internal Medicine/ Hospital Medicineo Cardiologyo Nursingo Pharmacyo Information Technology Serviceso Medical Recordso Performance Improvemento Case Management
![Page 5: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/5.jpg)
CHF Core Measures Team
Medicine Program/House Staff Leadership:o Developed a set of “discharge instructions” specific
to Congestive Heart Failure (CHF)o Added “smoking cessation” to all d/c instructionso Developed MIS “physician” prompt/reminder for
ACEI/ARB inclusion in CHF d/c instruction pathwayo Ensure MIS d/c instructions are comprehensive &
include CHF “reminders” for patients with CHF as a secondary diagnosis
o Consolidated d/c instructions and d/c summaries for patients with 2-5 day length of stay (LOS)
![Page 6: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/6.jpg)
Heart Failure Core Measure Set
Discharge Instructions LVF Assessment ACEI/ARB for LVSD Adult Smoking Cessation
Advice/Counseling
![Page 7: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/7.jpg)
Discharge Instructions
Activity Diet Follow-up Medications Symptoms Worsening Weight Monitoring
![Page 8: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/8.jpg)
Discharge Instructions
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
![Page 9: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/9.jpg)
Left Ventricular Systolic Function
LVF Assessment (Before arrival, during hospitalization, planned for after discharge)
![Page 10: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/10.jpg)
Left Ventricular Systolic Function
90%
92%
94%
96%
98%
100%
Co
mp
lia
nc
e
![Page 11: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/11.jpg)
ACE-I or ARB for LVSD
ACE-I or ARB Prescribed at Discharge Contraindication to ACE-I or ARB @ Discharge
![Page 12: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/12.jpg)
ACE-I or ARB for LVSD
90%
92%
94%
96%
98%
100%
Co
mp
lia
nc
e
![Page 13: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/13.jpg)
Smoking Cessation
Adult Smoking Counseling Adult Smoking History
![Page 14: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/14.jpg)
Smoking Cessation
80%
85%
90%
95%
100%
Co
mp
lia
nc
e
![Page 15: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/15.jpg)
THANK YOU!!!
![Page 16: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/16.jpg)
Medication Reconciliation
GMEC QI Presentation
![Page 17: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/17.jpg)
Medication Reconciliation
Reconciliation is a process of comparing an accurate list of a patient’s “current” medications — including name, dosage, frequency, and route — with those ordered for the patient while under the care of the hospital
Reconciliation involves comparing the patient’s current list of medications against the admission, transfer, and/or discharge medication orders.
Joint Commission National Patient Safety Goal #8
![Page 18: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/18.jpg)
Admission Medication Reconciliation
History & Physical is present History & Physical is “current” version History & Physical is “Dated” and
“Timed” Medication Inventory is complete Medication Instructions are provided Medication was “taken today”
![Page 19: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/19.jpg)
History & Physical is present
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
![Page 20: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/20.jpg)
History & Physical is “current” version
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
![Page 21: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/21.jpg)
History & Physical -“Dated” and “Timed”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
Date Time
![Page 22: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/22.jpg)
Medication Inventory is complete
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
![Page 23: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/23.jpg)
Medication Instructions are provided
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
![Page 24: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/24.jpg)
Medication was “taken today”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Co
mp
lia
nc
e
![Page 25: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/25.jpg)
Please DO:
DO assure retention within the medical record of patient-provided medication lists by writing “Retain in Permanent Medical Record” across the top of the list.
DO answer the MIS prompt regarding a patient’s contraindication to ACEI and/or ARB therapy for patients with LV dysfunction for whom you are not prescribing an ACEI or ARB at discharge
DO list the names & doses of all medications the patient will be taking after discharge within the MIS discharge instructions or within any other discharge instructions given to the patient (e.g., Heart Failure Service discharge instruction form).
![Page 26: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/26.jpg)
Please DON’T:
DO NOT write “resume home medications” or “resume current medications” or “follow home regimen” on the discharge note, on the discharge instructions, or on the dictated discharge summary.
DO NOT list or mention any discharge medications in a problem list within the dictated discharge summary or discharge progress note.
DO NOT list or mention any discharge medications. Doing so forces a (100%) reconciliation process with the medications on the MIS discharge instructions. A single non-match causes non-compliance (0%).
![Page 27: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/27.jpg)
Heart Failure Core Measures & Medication Reconciliation
Keep Up the Good Work!
Pick Up & Follow the Trend!
Let’s Take It to the Next Level!
![Page 28: Heart Failure Core Measures GMEC QI Presentation.](https://reader030.fdocuments.net/reader030/viewer/2022032802/56649de95503460f94ae4152/html5/thumbnails/28.jpg)
THANK YOU