美国心力衰竭管理指南(心衰指南)课件要点.ppt

Coordinating Care for Patients With Chronic HF Effective systems of care coordination with special attention to care transitions should be deployed for every patient with chronic HF that facilitate and ensure effective care that is designed to achieve GDMT and prevent hospitalization. Every patient with HF should have a clear, detailed and evidence-based plan of care that ensures the achievement of GDMT goals, effective management of comorbid conditions, timely follow-up with the healthcare team, appropriate dietary and physical activities, and compliance with Secondary Prevention Guidelines for cardiovascular disease. This plan of care should be updated regularly and made readily available to all members of each patient’s healthcare team. Palliative and supportive care is effective for patients with symptomatic advanced HF to improve quality of life. I IIa IIb III I IIa IIb III I IIa IIb III Quality Metrics/Performance Measures Guideline for HF Quality Metrics/Performance Measures Performance measures based on professionally developed clinical practice guidelines should be used with the goal of improving quality of care for HF. Participation in quality improvement programs and patient registries based on nationally endorsed, clinical practice guideline-based quality and performance measures may be beneficial in improving quality of HF care. I IIa IIb III I IIa IIb III ACCF/AHA/AMA-PCPI 2011 HF Performance Measurement Set Measure Description* Care Setting Level of Measurement 1. LVEF assessment Percentage of patients aged ≥18 y with a diagnosis of HF for whom the quantitative or qualitative results of a recent or prior (any time in the past) LVEF assessment is documented within a 12 mo period Outpatient Individual practitioner 2. LVEF assessment Percentage of patients aged ≥18 y with a principal discharge diagnosis of HF with documentation in the hospital record of the results of an LVEF assessment that was performed either before arrival or during hospit