Heart Failure FAQs
FAQ: Heart Failure Accreditation Services
Maghee Disch, MSN, RN, CNL, CHFN, AACC
Accreditation Service Line Specialist
Maghee Disch has spent her entire medical career working with the Heart Failure patient population. Her knowledge and expertise of patient care delivery is both respected and valued within her field. Disch also serves as a committee member for both Heart Failure Society of American and American Association of Heart Failure Nurses. Most recently, Disch and a team of Heart Failure experts have developed and launched the third and newest version of Heart Failure Accreditation. With a focus on decreasing mortality and improving quality of life HF v3 is reaching new heights in elevating the management of the Heart Failure population.
A: My personal mission, which aligns with our organization is reduce mortality from cardiovascular disease. The HF tool was created to decrease death and improve quality of life through process improvement and optimal patient care delivery systems. Our patients and their families remain at the center of all we do and that includes the build of all of our products.
A: Recognizing the growing number of LVAD and Transplant facilities it was deemed necessary to add more complete criteria and processes for these type of institutions. The larger academic facility requires different strategies versus a rural or community center.
A: For example, it is Mandatory that the facility has a process in place to objectively identify patients who fail to respond/progress clinically which includes a referral/consult to the appropriate provider (Cardiology, HF Cardiologist, Advanced HF center, Palliative Medicine, etc.)
A: The Calculated Measures or metrics compiled from our unique database give visualization of length of stay for all levels of care. In addition to this, facilities are able to track Observation order set utilization, rate of Cardiology consult and Observation to Inpatient conversion. This information is vital to understanding and evaluating the processes within Observation Services.
A: Most definitely, this type of patient level data would have been extremely beneficial. Working in such a large institution I was unable to get many of the data points I desired unless I kept track of them on my own through a self-created and very simplistic database. Without the right data it was very difficult for me to show administration (C-suite) where there were opportunities for improvement.
A: With our resources and criteria hospitals will be able to increase specialized knowledge and decrease variance in care. With standardized order sets and increased order set utilization metrics will improve in all areas not just one.
FAQ: Heart Failure
Dr. Philip D. Levy
ACC Accreditation Management Board Member
Assistant Professor of Emergency Medicine Associate
Director of Clinical Research Dept. of Emergency Medicine Wayne State University
A: Process measures such as the proportion of eligible patients who receive beneficial medications not tracked by CMS metrics (i.e., beta-blockers, aldosterone antagonists, and isorbide dinitrate/hydralazine), the proportion who receive and attend a post-discharge appointment, and the use of Palliative Medicine consultation for end-stage patients will be of tremendous value. Additionally, the inclusion of outcome measures beyond simple mortality or recidivism along with more extensive breakdown of the time frames for their occurrence will be important.
A: They will provide insight into how processes of care affect things that actually matter to patients, payers and governmental agencies. Most process improvement initiatives stop at the process itself -- including outcome measures rounds out the picture telling what, beyond the ability to change an approach or intervention, the improvement initiative can achieve. In effect, it provides an assessment of return on quality telling institutions where they should put resources to better the health (not just the healthcare…) of their patients.
A: Figure out where to put your investment in people, clinics, etc., so that you can optimize management of your HF patients.
A: This will provide an evidence-based approach to management of the HF patient and help you figure out which processes and procedures you should be putting into place. As the tool is a "living" thing, data will evolve over time helping you hone in on what are truly best practices.
A: Yes. Data, criteria within the line items, references and shared practices will be updated as often as the science changes and at the minimum reviewed and enhanced on a quarterly basis.