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Sunday, November 1, 2009
Learning Objective 1: identify approaches to accurately identify hospitalized heart failure patients.
Learning Objective 2: discuss strategies to implement evidence based treatment for hospitalized heart failure patients.
Background: Heart failure (HF) affects 5 million Americans and is associated with a tremendous economic burden, resulting in 34.8 billion dollars in health care expenditures each year.1 Hospitalizations for acute decompensated HF comprise nearly half of the reported expenditures.1 The purpose of this study was to examine the outcomes of hospitalized HF patients following implementation of an evidence based program.
Methods: An evidence based program was implemented across the continuum of care at a Mid-western acute care facility. Multiple approaches were implemented to ensure accurate identification of patients with primary and secondary HF diagnosis. Education of care providers, development of a computerized tracking tool, automated results reporting of important laboratory values for inpatients were a few of the initiatives implemented. A retrospective review of HF indicators prior and following implementation of the evidence based program revealed positive results.
Results: Overall hospital admissions from 2004 to 2008 increased by 7.8%. Quality indicators prior and following implementation of the program are as follows: Completed discharge instructions (80/98.8%), assessment of left ventricular function (85.8/99.8%), implementation of ACE Inhibitor (76.6/99%) and smoking education (69.2/100%). Heart failure admissions decreased by 38% from 2004 to 2008. Program cost is the salary of 2 full time Registered Nurses.
Conclusion: Implementation of evidence based care is critical to improving outcomes of this patient population. Through accurate patient identification, monitoring and communicating with care providers, increased utilization of evidence based care and reduced healthcare costs will result.
Methods: An evidence based program was implemented across the continuum of care at a Mid-western acute care facility. Multiple approaches were implemented to ensure accurate identification of patients with primary and secondary HF diagnosis. Education of care providers, development of a computerized tracking tool, automated results reporting of important laboratory values for inpatients were a few of the initiatives implemented. A retrospective review of HF indicators prior and following implementation of the evidence based program revealed positive results.
Results: Overall hospital admissions from 2004 to 2008 increased by 7.8%. Quality indicators prior and following implementation of the program are as follows: Completed discharge instructions (80/98.8%), assessment of left ventricular function (85.8/99.8%), implementation of ACE Inhibitor (76.6/99%) and smoking education (69.2/100%). Heart failure admissions decreased by 38% from 2004 to 2008. Program cost is the salary of 2 full time Registered Nurses.
Conclusion: Implementation of evidence based care is critical to improving outcomes of this patient population. Through accurate patient identification, monitoring and communicating with care providers, increased utilization of evidence based care and reduced healthcare costs will result.
1. American Heart Association. Heart disease and Stroke Statistics-2008 update. Dallas Texas. American Heart Association. 2008.