Best Practices - HF

The Centers for Medicare & Medicaid Service (CMS) and The Joint Commission (TJC) together developed core measures to be used to increase quality of care for patients with heart failure. The measures related to treatment for heart failure are:

• Performing a left ventricular function (LVF) assessment
• Giving an ACE inhibitor for left ventricular systolic dysfunction
• Giving full instructions at discharge
• Providing advice/counseling on how to stop smoking

The definition of and rationale for the selection of these measures is found in the document “Current Specification Manual for National Hospital Quality Measures" which can be found on the Joint Commission's website:  http://www.jointcommission.org/PerformanceMeasurement/
PerformanceMeasurement/Current+NHQM+Manual.htm

Practitioners should stay up-to-date on the current care practices to ensure they provide the best care for their patients. The following example documents were created to assist practitioners to provide adequate care:

• An online, full-text version of ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult is provided by The American College of Cardiology (ACC) and the American Heart Association (AHA). Find these guidelines at: http://www.americanheart.org/downloadable/heart/5360_hfguidelinefinal.pdf
• Clinical Performance Measures for Heart Failure offers measures and a data collection flowsheet pertaining to the Heart Failure Core Physician Performance Measurement Set. The guide is provided by the ACC, AHA, and Physician Consortium for Performance Improvement. It is located on the AHA website at: http://www.americanheart.org/downloadable/heart/1055798256692HFMiniSetR030157_final.pdf
• Arkansas Foundation for Medical Care provides printable Heart Failure Education Labels that encourage and document discussions about heart failure with the patient. The labels are available in Excel format at the following link: http://www.afmc.org/documents/quality_improve/qi_tools/averylabels/
  Avery5163HeartFailureEducationLabel%20.xls
• The Heart Failure Society of America tracks research progress in the area of heart failure on its website. Visit the Latest Developments area of website for updates.
• Additional science and professional publications are available from the AHA website at the following link: http://www.americanheart.org/presenter.jhtml?identifier=3004550

Practitioners can assist patients with understanding disease and the procedures and care for heart failure. A variety of media are available including:

• The Heart Failure Society of America publishes a series of documents designed to help patients better understand their care and treatment. View or print the documents from the following link: http://www.hfsa.org/heart_failure_education_modules.asp
• The American Heart Association provides a printed informational brochure for patients with heart failure. You can request the brochure at the following link: http://www.americanheart.org/presenter.jhtml?identifier=9258
• The Maryland Health Care Commission Hospital guide website contains descriptive information about heart failure at:
  http://mhcc.maryland.gov/consumerinfo/hospitalguide/
  practitioners/technical_information/chf_information.html

This website provides details on the performance for all Maryland Hospitals for all four measures identified previously on this page. You should become familiar with this performance information to be able to answer questions from your patients regarding Hospital performance and the core measure set for patients with heart failure.