Welcome to the Cardiovascular Clinical Program!
Intermountain Healthcare continues to be recognized as a national leader in research and provision of best practices in cardiovascular care. See how we monitor, measure, report, and improve these processes:
2013 CV Clinical Program Board Goal:
This goal is a multi-faceted approach to treating hospitalized patients with a primary diagnosis of heart failure at all Intermountain Healthcare hospitals. The components of this goal will serve to accurately identify patients with a primary diagnosis of heart failure within twenty-four hours of admission, and prioritize and apply a consistent care process model to be followed by caregivers in order to optimize clinical, service and value outcomes across the continuum of care. This two-year goal is comprised of the four elements listed below:
- Accurate and timely identification of patients coded with a primary diagnosis of heart failure.
- Refine the identification methodology for heart failure patients.
- Develop a best practice strategy for risk adjusted management of heart failure patients.
- Develop and distribute best practice guidelines to identify appropriate patients for advanced heart failure therapies including implantable cardioverter-defibrillators (ICD) and/or cardiac resynchronization therapy (CRT) to reduce hospitalizations and death rates among patients with heart failure. Additional advanced heart failure therapies include left ventricular assist device (LVAD) and/or transplant.
- Optimize the measurement and reporting systems for heart failure patients.
- Measure and report all-cause mortality rates within thirty days of hospitalization for patients with a primary diagnosis of heart failure.
- Measure and report readmission rates within thirty days of hospitalization for all causes for patients with a primary diagnosis of heart failure and for cardiac specific readmission rates for patients with a primary diagnosis of heart failure.
- Compare mortality rates and readmission rates to national benchmarks. Establish goals for these measures in 2014.
- Begin developing the ability to measure and report inpatient variable cost per case for heart failure patients.
- Standardize the entry and reporting of the post discharge phone call database.
- Achieve the 2013 Value Based Purchasing and Core Measure heart failure goals.
- Heart Failure-1 Discharge instructions (VBP) >98%
- Heart Failure 30-day mortality rate (VBP) <11%
- Heart Failure-2 Evaluation of left ventricular systolic function >98%
- Heart Failure-3 Angiotensin Converting Enzyme Inhibitor (ACE-I) or Angiotensin II Receptor Blocker (ARB) >98% and Beta Blocker for left ventricular systolic dysfunction >95%
- Heart Failure 30-day Risk Standardized Readmission Measure <19%
- Transition Phase (Hospital to Home)
- Optimize the transition phase from hospital to home to improve patient care readmission rates within thirty days of hospitalization.
- Develop a process for calling patients within seventy two (72) hours of discharge from each facility. Specific goal will be established in 2014.
- Improve patient medication communication prior to discharge.
- Implement a process for scheduling patients for a follow-up appointment within seven days of discharge. Establish measurement and a baseline for this process in the first quarter of 2013. Establish hospital specific goals for improvement in the third quarter of 2013. Achieve eighty five (85) percent compliance in 2014.
- Require ninety (90) percent of patients with a primary diagnosis of heart failure to be discharged using the electronic discharge medication program.
- Work collaboratively with Intermountain’s Integrated Care Management Team and SelectHealth to enhance the care of discharged patients in the outpatient setting and identify process improvement goals for 2014.
Methodology: Each goal will include detailed and specific milestones for years one and two. The Cardiovascular Clinical Program proposes to measure the overall completion of the Clinical Board Goal by producing a composite percentage of completion for each year to be reported at the end of the third quarter of 2013 and 2014 respectively.
Facility specific goals will be determined by the end of the first quarter of 2013 and the measurement system will be established by the third quarter of 2013. Standard project management tools will be used to represent and track the stages and activities of the project. Statistical process control tools will be used to assess if the proposed goals are having the desired beneficial effect as well as reduce any variation that may exist between clinics across the system with respect to specific outcomes including readmission, mortality, and delivery of patient education.
Measurement Time Period: Third Quarter 2013
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