Purpose:

To examine a process by which to identify heart failure (HF) core measures concurrently and to influence hospital outcomes in relation to HF.

Significance:

Quality indicators for HF are known as core measures. These measures guide hospitals to identify areas for clinical improvement and maximize reimbursement. Although most hospitals are collecting and submitting data for HF core measures, few have developed methods other than retrospective review that may require up to 3 months to collect and analyze data for submission. Retrospective chart review is often cumbersome and inefficient. Concurrent data collection for HF core measures allows hospitals to monitor their performance and institute any changes that would enhance clinical outcomes.

Design/Background/Rationale:

Clinical quality indicators for HF are being monitored and compared to national benchmarks by the Joint Commission (JCAHO) in order to document performance of evidence-based medicine.

Methods/Description:

A large tertiary hospital has developed a methodology for identifying the patients admitted with HF and has designed a process for concurrent rounding for data collection. After initiating the pilot process, 75% of the patients who were discharged with primary diagnosis of HF were identified and evaluated by concurrent data collection.

Findings/Outcomes:

Furthermore, the results of the core measures improved significantly with this "real-time approach." There was a significant improvement for HF core measures: discharge instructions, weight management, diet, activity, medications, and signs and symptoms. Also, smoking assessment and counseling for cessation increased by 24%.

Conclusions:

In addition to this improvement, the method proved to be more efficient and cost effective as less time was required for retrospective chart review and more current data were available to analyze.