ATTENTION ALL IES PROVIDERS:
Congratulations! We have been able to decrease heart failure admissions by about 10% for the system from 2018 to 2019! Below is a reminder of our approach so that we can continue to take great care of our heart failure patients.
REVIEW OF PROJECT
Problem:
The general approach historically was to automatically admit the symptomatic heart failure patient seeking care in the ED. General admit rates throughout the country and our regional system run between 80 and 100%.
Reasons to Reconsider this Automatic Admission Plan:
1. Yes, these patients are high risk, but there has been no evidence to support that admission decreases morbidity and mortality.
2. Iatrogenic complications and nosocomial infections may be avoided
Goals of Project:
1. Improve our care of heart failure patients by using a comprehensive heart failure guideline to guide assessment, management, and disposition.
2. Decrease our overall heart failure admission rate.
The Heart Failure Guideline Summary (5 tiers):
1. Assess level of distress
a. Be an ER doc!
2. Assess level of congestion
a. Look at neck veins…and all of your information
3. Aggressive diuretic protocol with REASSESSMENT!!!
a. REASSESS with attention to possibility of discharge
4. Mortality risk assessment
a. Understand they are all high risk , but not all require admission
5. Discharge planning
a. Work with your cardiologists to see if you can get expedited follow up.
Heart Failure Guideline Update
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