Chronic heart failure (CHF), an often fatal chronic condition affecting an estimated 4.8 million Americans, is the most common diagnosis of hospitalized patients over age 65, according to the National Institutes of Health (NIH). Prevalence of the disease is at least 25 percent greater among black people than white people. As the population ages and cardiac patients are increasingly able to survive and live longer with their disease, the prevalence of CHF is expected to increase.
A nationwide effort is underway to better understand the causes and improve the prevention, diagnosis, and treatment of CHF, which has been identified as a Joint Commission Core Measure for quality improvement.
Montefiore Medical Center conducts a number of CHF-related quality improvement efforts, including the following:
- ACE Inhibitors and ARBs
The use of angiotensin-enzyme (ACE) inhibitors at discharge is a publicly reported performance measure for CHF and heart attack patients with left ventricular dysfunction. Montefiore has designed an algorithm that identifies hospital patients with heart attack and CHF, and a chart reminder is underway to increase appropriate use of ACE inhibitors and ARBs.
- Network Performance Report
The Montefiore Medical Center Network Performance Group produces a highly customized monthly report that enables medical leadership and governing bodies to obtain a quantitative snapshot of the current state of the organization. Included in the report's analysis areas are several measures of care for CHF inpatients.
- Door-to-Balloon Initiative
Timely provision of a balloon angioplasty significantly reduces heart muscle damage associated with heart attack. Montefiore’s new streamlined protocol has resulted in a highly successful door-to-balloon record.
- Smoking Cessation
Montefiore Medical Center has implemented a multifaceted smoking cessation counseling strategy geared particularly toward patients with CHF.
The Montefiore Medical Center Heart Transplant & Assist Device Program participates extensively in quality assurance and performance improvement activities.