1 / 13

Improving Heart Failure Management in Skilled Nursing Facilities

Improving Heart Failure Management in Skilled Nursing Facilities. AMDA Foundation/Pfizer Quality Improvement Award. Rebecca S. Boxer, MD Assistant Professor of Medicine. Heart Failure is the Most Common Reason for 30-Day Rehospitalization. Jencks N Engl J Med 2009.

terri
Download Presentation

Improving Heart Failure Management in Skilled Nursing Facilities

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Improving Heart Failure Management in Skilled Nursing Facilities AMDA Foundation/Pfizer Quality Improvement Award Rebecca S. Boxer, MD Assistant Professor of Medicine

  2. Heart Failure is the Most Common Reason for 30-Day Rehospitalization Jencks N Engl J Med 2009

  3. Hospital Discharges for Heart Failure by Age and Sex (FHS: 1980-2003). Source: NHLBI. * HF based on physician review of medical records and strict diagnostic criteria.

  4. Discharge Status from the National Hospital Discharge Survey 1980-2004 % *LTC includes NH and SNF Fang JACC 2008;52:428–34

  5. Hospital to Home(does not include SNF) A national quality improvement initiative of the American College of Cardiology and the Institute for Healthcare Improvement Goal Reduce 30 day, all-cause readmission rates for patients discharged with cardiac conditions by 20 percent by December 2012.

  6. The Bridge Project • Assess the HF Management in 4 SNF in Greater Cleveland area And then • Identify needs of SNF • Create HF disease management program for SNF

  7. Results from 4 Facilities • No HF disease management programs • No tracking of patients with HF • Inadequate dietary flexibility • Poor symptom recognition • No medication titration protocols or flexible diuretic regimens Boxer et. al. JAMDA 2011 in press

  8. AMDA Foundation/Pfizer Quality Improvement Award Preparing the SNF for change in HF Management • Program to Educate all Staff • Train the Trainer • Develop multi-media tools to teach both staff and patients

  9. Results from HF Educational Program Boxer et. al. JAMDA 2011 in press

  10. Development of HF Teaching Videos • Nurse teaching STNA to manage HF • STNA teaching Patient to manage HF • Nurse teaching family to manage HF - Focus Group Assessment – Motivational Interviewing Techniques added STNA = State Tested Nurses Aide

  11. Thanks to: Ileana Piña MD, MPH Mary Dolansky RN, PhD Jeanne Hitch Med, MA Peter Degolia MD Matthew Wayne MD Megan Frantz, BA Regina Prosser RN-BNC AMDA Foundation/Pfizer Quality Improvement Award The McGregor Foundation CWRU/Mt Sinai Skills and Simulation Center Case/Cleveland Clinic Multidisciplinary Clinical Research Training Program; 1KL2RR024990 The Bridge Project a Collaboration

More Related