Transcript CHF Program - Texas Center for Quality & Patient Safety

The Impact of
Congestive Heart Failure
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5.2 million people affected in the US
400,000 new cases diagnosed each year
Responsible for 870,000 hospital admissions per year
200,000 people die of CHF each year
$38.1 billion annually (predicted to rise to $44.6
billion by 2015)
Family Practice Notebook (http://www.fpnotebook.com/)
 What can we do?
Goals
 Educate participants (and their
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caregivers) concerning their
disease process
Decrease admission/readmissions
to the hospital
Optimize medical therapy
Have 100% of inpatients with a
diagnosis of CHF referred posthospitalization
Equip participants with the
necessary tools to maintain and
possibly improve their personal
level of optimal health.
Our Model
 Combination of education and exercise
 Six weeks program on a revolving basis
 All participants in the program must be
under the care of a primary care
provider.
 Optimization of medical therapy is
under the direction of each individual
provider.
 A progress report is sent to the PCP after
the initial visit, midway through the
program and again at discharge.
 $25 participant charge for the program
Before Getting Started
 Baseline EKG (if not done
in the past 2 weeks) with
further work-up if ectopy is
noted
 Pre-entry labwork (if not
done within the past 90
days)
-CMP, CBC, BNP
 Echocardiogram (if not
done within one year prior
to admission)
Managing a Chronic Disease
 We can’t expect patients to
manage chronic conditions
such as congestive heart
failure without giving them
the tools to do so.
 Equipping them with
knowledge gives them the
ability to actively
participate in their own
care.
Education: The Key to Success
 Medical Terms and
Cardiac Anatomy
 CHF: What is it?
 CHF Management
 Sodium and Fluid
 Reading Nutrition
Labels
 Monitoring Your Weight
 Medications
 The Importance of
Exercise
 Signs/Symptoms of
Exacerbation
 Tests and Interventions
 Sudden Heart Failure
 End-of-Life Decisions
and Care
Plan
 Track admissions and
readmissions for CHF
exacerbations for one
year following
completion of the
program
 Ongoing outcome data
will be shared with the
Medical Staff and the PI
Committee
Thus Far…
Start
 MET levels
1.5 -2.5
Finish
2.0-2.9
 Exercise Time
17-23 minutes
35-37 minutes
 100% of participants reported a
positive improvement in their
confidence level.
Questions?