First Steps

GARNERING INSTITUTIONAL SUPPORT, ASSEMBLING A TEAM, TEAM RULES, AND UNDERSTANDING THE FRAMEWORK FOR IMPROVEMENT

Introduction: Recognizing and Defining the General Quality Problem

Quality improvement projects should always develop from recognition of a gap between the level of care that is optimal and best supported by the evidence contrasted with the care that is actually being delivered to our patients.

Optimal Care for the Heart Failure Patient

Team leaders need to be thoroughly familiar with the principles of the management of heart failure in the hospital and across the care continuum. Reviewing the appropriate sections in the Heart Failure Resource Room including review articles, position papers, and guidelines, and reviewing the annotated bibliography of key literature in the Heart Failure Room should bring you up to date quickly if you are not already well versed in this literature.

Looking into the Gap

Analyze Care Delivery lets you to delve into the details of the care you currently provide and to recognize opportunities for improvement, while the metrics needed to accurately and reliably measure the quality of care your patients enjoy is fully outlined in Track Performance. A multidisciplinary approach and institutional support are needed to really complete these sections. You may already have successfully used your own methods for convincing yourselves and your administration that inpatients with heart failure receive suboptimal care (either by anecdote or hard data) to such a degree that you have already garnered full institutional support and a complete multidisciplinary team. If this is not the case, you will need to make a case for improving the care of patients with heart failure. Key information to review includes data on your hospital’s heart failure core measures, length of stay, readmission rate (after 8 and 30 days), and mortality (in hospital and after 30 days).