Identifying Patients with Heart Failure

The key concept is routine. You cannot improve the care of a patient group without a strategy to identify patients with that condition in real-time. Frequently patients with heart failure are admitted with dyspnea or other non-specific complaints and it may not be clear that a patient has a heart failure diagnosis. Furthermore, patients may be admitted to a variety of hospital units, many of which may have minimal experience working with heart failure patients.

In some instances the diagnosis of heart failure can be elusive and complicated. In these instances, real-time case finding is especially valuable. In the literature, this identification process is frequently assumed to be a straight-forward one, but this may not be true in clinical practice. Ensuring a standardized identification strategy is critical to targeting whatever interventions the group may propose.

Identification strategies may include links to specific data such as ejection fractions or B-type natriuretic peptide (BNP) values, or use of medications such as intravenous loop diuretics. One organization has used the receipt of an intravenous loop diuretic as a strategy to identify potential patients with heart failure (Sensitivity 0.89 and Specificity of 0.87).