Improved care for patients with congestive heart failure

Jt Comm J Qual Patient Saf. 2008 Jan;34(1):13-9. doi: 10.1016/s1553-7250(08)34003-3.

Abstract

Background: Congestive heart failure (CHF) affects 4.9 million people, mostly elderly, in the United States; 550,000 new cases are diagnosed each year. Evidence-based treatment approaches offer opportunities to reduce mortality, complications, and rehospitalization rates.

Strategies to improve care for patients with congestive heart failure: Seven key components of care tailored to the patient's clinical condition and comorbidities that should be provided to all patients with CHF, in the absence of contraindications or intolerance: (1) left ventricular systolic function assessment, (2) angiotension-converting enzyme-inhibitor or angiotensin receptor blockers at discharge for CHF patients with systolic dysfunction (left ventricular ejection fraction < 40%), (3) anticoagulation at discharge for CHF patients with chronic or recurrent atrial fibrillation, (4) smoking cessation advice and counseling, (5) discharge instructions that address activity level, diet, discharge medications, follow-up appointment, weight monitoring, and what to do if symptoms worsen, (6) influenza immunization (seasonal), and (7) pneumococcal immunization. Hospitals should also consider beta-blocker therapy at discharge for stabilized patients without contraindications.

Conclusion: The 5 Million Lives Campaign's focus on delivering reliable, evidence-based care for patients with CHF is part of an overall strategy to reduce medically induced harm.

MeSH terms

  • Aftercare / standards
  • Evidence-Based Medicine*
  • Family
  • Health Behavior
  • Health Promotion
  • Heart Failure / drug therapy
  • Heart Failure / prevention & control*
  • Hospitals / standards*
  • Humans
  • Organizational Objectives
  • Patient Discharge / standards*
  • Patient Participation
  • Patient Transfer
  • Quality Assurance, Health Care / methods*
  • United States