SCAN
NCH
May 2013

Heart Failure Quality Measures

Heart failure core measures are quality indicators that equate to pay for performance. The core measures for heart failure include documentation of left ventricular ejection fraction in the current medical record and prescribing of ACE-I/ARB at time of discharge when left ventricular ejection fraction is less than 40 percent or a clearly documented contraindication in the current medical record. Patient education is another key component and should include six items: diet, medication, weight management, activity, follow-up care, and what to do if symptoms worsen.

Our heart failure quality indicator scores remain very high with the exception of the medication element. This measure requires a perfect match between the medication section of the dictated discharge summary and the printed medication list patients are sent home with.

It is difficult to know exactly what medications the patient will go home on until the last care provider has reviewed and signed the medication reconciliation sheet. Therefore, to ensure we satisfy the core measure for medication, the medication section of the discharge summary should be dictated to say "see medication reconciliation list." This way, the data abstractor has only one document to review and there is no chance of a mismatch/fall out.

In closing, heart failure is one of the leading causes for admission and readmission to hospitals in the U.S. By providing care as established through evidence-based medical research and great patient teaching, the experts feel these patients will be able to handle their health issues better and improve their quality of life, therefore reducing the number of hospital stays.