Transcript Earlier Identification of CHF Patients

Earlier Identification of CHF Patients
30% of CHF
Patients
Identified
70% of CHF
Patients
Identified
Benefits of Earlier Identification
CHF Specific Interventions
New CHF
Identification
Innovation
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CHF Bundle
Fit for Life Consults
Palliative Care Consults
Disease specific discharge education
Set up follow-up appointment with
provider
Patient Quick Guide (Stoplight)
Discharge Trigger
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Identification Criteria
Identification Criteria
Primary Diagnosis Code CHF
Principle Problem CHF
CHF-related order sets used
CHF on Active Hospital Problem List
(including Cardiomyopathies)
Point Value
100
100
40
80
CHF-associated Medications:
(Digoxin, Nitrates, Beta Blockers, Vasodilators, Diuretics, HMG CoA Reduct
Inhib, Calcium Channel Blockers, ACE Inhibitors, ARB)
 3 or more of the above medications
NT-proBNP value
 Result Positive: <50 yrs: >450 pg/ml; 50-75 yrs: >900 pg/ml;
>75 yrs: >1800 pg/ml
Echo ordered or resulted during encounter
 Ordered within 7 days
40
40
40
This Identification Tool is additive.
The threshold for potential CHF identification is 100 points.
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Who will receive notification?
– From Sepsis PI-LDP Team Survey:
• Bedside Nurse
• Attending Physician
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Next Steps
• Sub-Phase Development
• Orders Management Committee—June 1, 2016
• CHF Identification Innovation
– Manually pilot the CHF Identification Innovation Report with
Cardiovascular nursing and Cardiology –April 2016
– Request in Process to CDS Committee—June 1, 2016
• Nurse Driven Protocol
– Cardiology and ECOMS for approval—June 1, 2016
• Explore
– Dedication of portion of CHF Nurse Practitioner time to inpatient
setting
– Developing electronic version of CHF Bundle