1. Congestive Heart Failure Quality Initiatives

2. SRHS History of CHF Focus Team early 90’s, developed Care Map, adopted education materials and guidelines Team mid 90’s, wrote Duke Endowment and SRHS Foundation grant applications….started CHF Clinic 2001-CHF Health Management Specialist added, expanded Tele-Services CHF Program 2003-SRHS Foundation continues to support the program, CHF Clinic continues, CHF Team restructured 2004-CHF Clinic becomes Heart Failure Center- adds Outpatient Natrecor

3. CHF CORE Team Cardiologist Executive Director Heart Center VP Patient Care Services – Heart Center Director Health Management Nurse Practitioners- Heart Failure Center Cardiology Clinical Outcomes Specialist PharmD CHF Case Manager ED Physician

4. Quality Indicators HF CORE / Seventh Scope of Work LOS Readmit Rate Mortality Rate Physician Practice Specific Data- Severity Adjusted –LOS –Cost/Case –Readmit Rate –Mortality Rate

5. Improvement Tools Name ________ Date _______ Freshstart Smoking Cessation Class For more information and registration call toll free 1-877-455-7747___________________ ….. Your Healthcare Professional Smoking Cessation Prescription Smoking Cessation Advice/Counseling Incorporated into Care Manager Documentation System Incorporated into WITT Hemodynamic System (Cardiac Cath Lab) Provide Patient/Family with Smoking Cessation Prescription (Nursing Units, Cardiac Cath Lab, HF Center, Cardiac Rehab

6. Improvement Tools CHECKLIST FOR CARDIOVASCULAR DISEASE (ACS/ MI/ CHF/ CABG) YESCONTRA- INDICATED N / A 1)ASA  2)BETA BLOCKER  EJECTION FRACTION: _______________ 3)ACE-I FOR LVEF LESS THAN 40  4)ARB  5)LIPID PROFILE CHECKED  6)STATIN’S OR OTHER LIPID LOWERING DRUGS  7)SMOKING CESSATION  8)DIET/ EXERCISE (CARDIAC REHAB) 

7. More Tools HF Order Set HF Care Sequence Nursing PI Team –(Patient & Staff Education) ED Algorithms Medical Staff Peer Review

8. To Continue to Improve Provide consistency by following Standard of Care Patient & Family education during hospitalization Referrals to CHF Case Manager Referrals to Heart Failure Center Referrals to Tele-Services Referrals to Home Health/Hospice