Heart Failure 's Quality Improvement Essay

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

In the UK, reports show that heart failure has been affecting up to 2% of the population, over 900,000 people are living with heart failure, with 63,000 new cases being diagnosed each year (BHF, 2015). It costs the NHS £625 million per year, as a result of the high portion of emergency admissions, readmission and long length of inpatient stay (NHS Improvement, 2010). DH (2000) confirmed that Heart failure accounts for all cardiac admissions and the readmission rate can be as high as 50% within 3 months; also, it further estimated 50% readmission might be preventable. Unfortunately, Heart Failure can’t be cured, but early

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

This assignment will take the form of a case study on a current patient with heart failure being nursed in a community setting. Due to confidentiality and patient privacy, the patient discussed will be referred to as John¹.

Hospitals nationwide have been striving to reduce the rate of patient readmissions. Both the federal government and private insurers are tired of picking up the tab. In a 2009 study in the New England Journal of Medicine, researchers estimated that a year's worth of unplanned re-hospitalizations cost Medicare alone $17.4 billion. Congestive heart failure is a particularly big target, as one in four patients end up back in the hospital within 30 days of discharge. Starting in the fall of 2012, the government will cut Medicare reimbursements for hospitals with higher-than-expected 30-day readmission rates for heart failure and two other conditions: heart attack and pneumonia (Avril, 2011).

Congestive heart failure is a growing chronic condition in the United States that accounts for over one million hospitalizations and is responsible for 27% of patients with heart failure on Medicare are readmitted with 30 days of discharge (Hines, Yu & Randall, 2010). The intensity of the disease process poses a financial strain on both the patient and the payers, especially Medicare, as 10 per 1000 population are 65 years or older and therefore a Medicare beneficiary (Mozaffarian et al., 2015). Consequently, in order to gain control over this chronic disease and its cost burden, the government and policy makers have shifted the responsibility to the health care facilities through the creation of policies that affect hospital reimbursement based on readmission rates. As a member of the quality team at my facility, the Hospital Readmissions Reduction Program deeply impacts my practice and encourages the hospital as a whole to focus on improving multidisciplinary collaboration in pursuit of quality patient care, resulting in better outcomes and decreased readmissions.

the risk of unplanned readmission or death within 30 days of discharge after a heart failure hospitalization. American Heart Journal, 164(3). 365-372. Retrieved from: http://www.medscape.com/viewarticle/771215_print

Each year the number of readmissions of the heart failure patient within 30 days of discharge has grown. The Medicare division in relation with the Affordable Care Act is reducing the amount of money they are willing to pay for readmissions to the hospital. Hospitals are now more than ever looking for ways to reduce the number of readmissions to the hospital for the heart failure patient. The purpose of this paper is take a look at a program designed with to reduce the readmission rates of one hospital to reduce the number of readmission through improved education and follow up of the heart failure patient.

According to the Centers for Disease Control and Prevention (CDC) there are an estimated 5.1 million adults suffering from heart failure (2013). As the prevalence of heart failure continues to rise, one out of every nine deaths occur as a result of this chronic condition. Studies conducted at Yale found in Medicare age patients with heart failure, there is a median 30-day mortality rate of 11.1% and 5-year rate of approximately 50% (Alspach, 2014). According to Desai & Stevenson (2012), rising costs of care are in direct correlation to the number of hospital admissions related to a primary diagnosis of heart failure especially among adults age 65 years or older. The national rate for readmissions within 30 days is approximately 24.7%, consequently having

Policy makers are constantly searching for new innovative ways to increase quality patient care and lower Medicare program spending. One indicator of inadequate quality that results in increased Medicare spending is the rate of readmissions to the hospital. Heart Failure patients are on the top of that list. Readmission refers to a patient’s being hospitalized within 30 days of an initial hosptial stay. This seems to be an indicator of inadequate quality of care in the hospital or a lack of appropriate coordination of postdischarge care.

Readmission is defined as “an admission to subsection hospital within 30 days of a discharge from the same or another subsection hospital” for the same diagnosis or for a complication related to the initial diagnosis (American College of Emergency Physicians, 2015). According to the Robert Wood Johnson Foundation (2014) report, the annual cost of hospital readmission in the nation is about $41 billion. More importantly, hospital readmission disrupts patient’s life and decreases the quality of life (Padhukasahasram, Reddy, Li, & Lanfear, 2015). Consequently, due to the human and economic burden of hospital readmission, the Center for Medicare and Medicaid (CMS), in 2012 implemented penalty on hospitals that exhibit a high readmission for diagnoses of Heart Failure, Pneumonia and Septicemia. This action has resulted in the reduction of readmissions to hospitals specifically associated with

To contain the cost experienced by hospitals with HF readmissions, evidence based practice must be applied to avoid reduction penalties by CMS. Evidence base practice shows implementing effective outpatient measures have reduced HF readmissions by 14% to 87% (McClintock et al., 2014). These outpatient measures include case management, early follow-up care, heart failure clinics, cardiac rehabilitation, medication reconciliation regimen, mailing & telecommunications home health and targeting caregiver burden (McClintock et al., 2014). Subsequently, prior to discharge it is the responsibility of the nurse to advocate for the patient. Effective teaching and patient reinforcement of information is important to avoid readmissions of any time

Heart failure refers to the reduced functioning of the heart because of a previous heart attack or a long history of heart disease. It is more common for a person to have a lengthy history of heart problems for it to develop, but it can happen after one massive heart attack if the heart attack does a significant amount of damage. The heart is responsible for pumping blood through the arteries to oxygenate all of the organs and the brain, so if it isn't working as it should, there can be some dire consequences to one's health. Though it is treatable, most cases of heart failure are not reversible. But there are some ways that a person can improve their quality of life while they have the condition, though.

Many factors can have a robust effect on how healthcare is standardized, such as heart failure (HF). HF, a chronic illness, results when the heart is unable to pump the required amount of blood to meet the body demands (Centers for disease and control and prevention [CDC], 2016). HF is prevalent in 5.7 million adults in the United States (US) and financially impact the nation in cost estimating at 30.7 billion dollars a year (CDC, 2016). HF is the most expensive diagnosis and common source of hospitalization among individuals 65 and older (McClintock et al., 2014). In addition, if adequate discharge planning is not provided, it may result in hospital readmissions which will economically affect the reimbursement rate from healthcare payors.