title: A congestive heart failure project with measured improvements in care.
abstract: This project was designed to improve the in-hospital management of Medicare beneficiaries with congestive heart failure (CHF). Eleven hospitals were studied using two indicators: (a) assessment of left ventricular (LV) function, and (b) use of angiotensin converting enzyme (ACE) inhibitors in patients with systolic dysfunction. Baseline performance rates were obtained for 990 cases with the Diagnosis Related Group (DRG) 127 for CHF discharged January 1994 to December 1994. Baseline data feedback presentations in 1995 spurred quality improvement plans with interventions such as physician education, critical care maps, and standing orders. Follow-up abstractions were performed on 612 discharges October 1995 through April 1997. The study demonstrated 12% improvement (53% to 65%, p < .01) in assessing LV function and 20% improvement (54% to 74%, p < .01) in appropriate ACE inhibitor use. Projects emphasizing Health Care Quality Improvement Program (HCQIP) principles can successfully affect health care management for the Medicare population.
authors.affiliation: Alabama Quality Assurance Foundation, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: DeLong
authors.forename: R M
authors.initials: RM
authors.lastname: Allman
authors.forename: R G
authors.initials: RG
authors.lastname: Sherrill
authors.forename: N
authors.initials: N
authors.lastname: Schiesz
mesh_terms: D000407:Alabama; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002985:Clinical Protocols; D003625:Data Collection; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D006278:Medicare / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D011366:Professional Review Organizations; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors