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Heart failure (also called congestive heart failure) means the heart can't pump enough blood to meet the body's needs. A number of underlying heart conditions can lead to heart failure. Conditions such as coronary artery disease and high blood pressure can leave the heart too weak or too stiff to fill and pump efficiently.
One way to evaluate the care of patients diagnosed with heart failure treatment is to look at the percentage of patients receiving each of the measures appropriate for them. The goal for all medical facilities is to provide all of these measures to 100 percent of eligible (appropriate) patients.
The graph below displays the percentage of eligible Mayo Clinic patients diagnosed with heart failure receiving each of the appropriate care measures in the list above.
The quality measures listed in the table below are known as the "standards of care" for heart failure. This list includes the medical care widely accepted as the most appropriate form of treatment for the majority of patients diagnosed with heart failure.
Standards of care for heart failure |
An explanation of this care |
|---|---|
Percent of Heart Failure Patients with Left Ventricular Function (LVF) Assessment |
An LVF assessment is a measure of how well the heart is pumping. An echocardiogram is often used to determine LVF |
Percent of Heart Failure Patients Prescribed Angiotensin Converting Enzyme Inhibitor (ACEI) or Angiotensin-Renin Blocker (ARB) at Discharge for Left Ventricular Systolic Dysfunction (LVSD) |
The use of an ACEI or ARB for these particular heart failure patients improves symptoms and reduces the risk of death and other complications. |
Percent of Heart Failure Patients Given Adult Smoking Cessation Advice during their hospital stay |
Smoking cessation reduces health complications and death in all populations. Patients who receive smoking-cessation advice from their care providers are more likely to quit. |
Percent of Heart Attack Failure Patients Given Discharge Instructions |
These instructions help ensure heart failure patients and their families understand dietary and activity recommendations, prescribed medication regimen, daily weight monitoring, the signs and symptoms of worsening heart failure, and follow up care. |
Appropriate Care Measure (ACM) - HF |
The appropriate care measure reflects the percent of HF patients who received all the care interventions for which they were eligible. In other words, the best care possible. The ACM is a pass/fail measure at the individual patient level that asks whether eligible patients have received ALL of the appropriate care for the condition for which they are being treated. |
Before a team was charged in early 2007 to examine this metric in the context of national standards, Mayo Clinic began following guidelines for heart failure care outlined by the Institute for Healthcare Improvement. During the IHI effort, assembled teams were charged with implementing and monitoring compliance with IHI recommendations.
Key elements for improvement included:
Improving the communication with healthcare providers through a reminder card for providers to carry in their pockets, workroom posters and internal newsletters.
Providing direct feedback to physicians and nurses when process failures were detected during patient care.
Implementing paper checklists (rather than electronic files) to make sure all matters have been taken care of before dismissing patients from the hospital.
Using computer technology to make it easier for health care providers to document the care they give to their patients.
Using computer technology to create a process that double-checks the medicine given to patients to make sure it is appropriate.
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