What is Heart Failure? Heart failure (HF) is a common medical condition. About 5.7 million people in the United States have heart failure, and it is the cause of about 300,000 deaths each year. In heart failure, the heart does not pump enough blood to meet the body’s needs. Because the heart is not pumping effectively, blood is not able to deliver oxygen and nutrients to the parts of the body. As a result, fluid and waste products accumulate in parts of the body, such as lungs, feet and legs.
Heart failure (HF) is one of the most common reasons for admission at Baystate Health (BH) facilities and has been a focus of quality improvement efforts for many years. BH has participated in numerous projects over time, specifically focusing on optimizing quality of care while reducing length of stay, readmission, and mortality. In the past, each hospital established a quality action team to promote improvements in care and coordinate education programs for patients and staff. In 2003, all three BH hospitals began participating in public reporting of HF care through Hospital Quality Alliance (HQA). Baystate Medical Center also participates in the Hospital Quality Initiative (HQI) and is in the top 20th percentile of hospitals participating. As a result of these efforts, clinical practice guidelines/care sets were developed that focus on key components of care, including the use of appropriate medications (such as ACEi/ARB, and diuretics), the assessment of left ventricular function (LVEF), smoking cessation counseling, and detailed patient education at discharge. Additionally a Heart Failure Clinic/Program was established to provide specialized patient-appropriate therapy, optimize quality of life, and reduce readmissions across the continuum of care.
Highlights
Baystate Health Ambulance
BHA uses continuous positive airway pressure (CPAP) as a noninvasive device to help avoid endotracheal intubation in patients with heart failure.
- CPAP is easy to handle, simple to learn, effective in emergent situations, and decreases costs throughout the emergency healthcare spectrum.
- Use of CPAP decreases pre-hospital, emergency department, and/or in-hospital need for endotracheal intubation by improving the patient’s respiratory condition in a safer and less costly manner.
The use of pre-hospital CPAP at the time of patient contact has helped to reduce the time to definitive treatment in the emergency room by an average of 18 minutes.
Baystate Medical Center
Baystate Medical Center continues to provide outstanding care to patients with Heart Failure.
- 99% of patients with HF received every recommended intervention.
- 100% of patients with depressed LVEF received ACEi/ARB at discharge.
- New technologies, such as Telehealth, ultrafiltration, biventricular pacers, and cardiac resynchronization therapy, have been incorporated into our program.
- Feedback loops have been developed to provide timely information to all clinicians if they miss an opportunity to provide optimal care.
Baystate Mary Lane Hospital
Ongoing clinical education emphasizes that heart failure interventions need to be done not only when it is the primary diagnosis, but for any patient identified with heart failure as part of their clinical presentation.
- 100% of patients with HF received every recommended intervention.
- BMLH has sustained high rates of use of ACEi/ARB and in measurement of LVEF.
- Enhanced discharge documentation through CIS has resulted in more patient-friendly information on medications and has helped to increase satisfaction, communication, and handoffs.
Baystate Franklin Medical Center
Patients with heart failure at BFMC consistently receive evidenced-based care.
- A new multi-faceted program is being implemented with area agencies and nursing homes to help patients with this chronic condition so that they have fewer readmissions.
For more information on the Baystate Health Heart and Vascular Program
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For more information on Baystate Franklin Medical Center
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