SMR Palliative Care Forum The Intersection: Chronic disease and Palliative Care. Chronic Heart Failure
|
|
|
- Alexander McLaughlin
- 5 years ago
- Views:
Transcription
1 SMR Palliative Care Forum The Intersection: Chronic disease and Palliative Care. Chronic Heart Failure Bruce Jackson Physician (General Medicine, Nephrology, Cardiology) Inpatient ward service in General Medicine, and Palliative Care Medical Lead, Chronic Diseases service. Assoc Prof of Medicine (Monash University) Clinical Dean (Casey Hospital) Margaret Ryan Nurse practitioner Chronic Disease Service (Complex Care)
2 SMR Palliative Care Forum The Intersection: Chronic disease and Palliative Care. Chronic Heart Failure The Chronic Heart Failure Service at Monash Health Evolved from the Hospital Admissions Risk Management Program (HARP) Comprises multidisciplinary team that supports inpatient and outpatient management of CCF Physicians/Cardiologists Nurse practitioners Specialist nurses Pharmacist Clinical Psychologist/Psychiatrist Physiotherapist/Exercise physiologist Admin support.
3 MONASH HEALTH Inpatient Auditor generals statewide review of HEART FAILURE Across all three acute campuses of Monash Health, over 3 years, compared with all Vic Hospitals Relative Stay Index(RSI) Heart Failure 0.81
4 The Journey of People with Heart Failure: Using Data to understand the Continuum : Monash Health Data obtained from ICD10 coding systems (2014/15 financial year) 1/ Codes Heart Failure as a primary diagnosis 2/ Audit of patient files over their journey 3/ Focus Groups Authors Debra Gascard : Chronic Diseases program Nurse Practitioner Julie White : Chronic Diseases program Manager
5 Age and Gender Distribution of People with CHF Primary Diagnosis
6 Number of Hospital Presentations per Patient with a Primary Diagnosis of Heart Failure Number of Admissions Total patients Total Admissions Grand Total 1,057 1,389
7 Comorbidities Count of Inpatient Episode Id Diag Group Total Number per patient Other 2,622 Heart failure 1,389 Diabetes 1,322 Chronic kidney disease stage 2,3,4,5 504 Personal history of tobacco use disorder 393 Hypertension 364 Acute Kidney failure 349 Infection 341 Long Term insulin 228 Health service area 226 Atrial fibrillation and atrial flutter 199 COPD 134 Respiratory failure 109 Urinary symptoms 109 Hyperkalaemia 94 Anaemia 94 Hypokalaemia 91 Iron deficiency 88 Constipation 86 AMI 82 Hypo-osmolality and hyponatremia 79 Anticoagulants causing adverse effects 77 Mental and behavioural disorder due to substance abuse 71 History of noncompliance with medical treatment and regimen 68 Ulcer 67 Angina 45 Pressure area 38 Pain 30 Palliative care 29 Grand Total 9,328
8 Admission Speciality Discharge Specialty Description Casey Dandenong Clayton Grand Total General Medicine Emergency Cardiology
9 Subsequent Admissions ranked top 14
10 Evaluation and Management of Patients with Acute Decompensated Heart Failure Decompensation is most commonly due to Failed compliance non-pharmacological Salt and water Failed compliance pharmacological Diuretics Cardio active drugs Antihypertensives Aggravating non cardiac factors NSAIDs Infections Other drugs alcohol
11 Evaluation and Management of Patients with Acute Decompensated Heart Failure Decompensation is much less commonly due to further cardiac events, however they need to be excluded Ischemia/infarct Arrhythmia Electrolyte disturbances Pulmonary emboli..
12 Readmission rates (Crude) 332/1057 readmissions (all causes) 31% Of these only 112 from heart failure i.e. Heart failure readmission rate 112/ % This compares well with published benchmarks of 15-30% readmission rate
13 Outcome of acute admissions Discharge to home 67% Discharge to Rehab 19% Discharge to residential care 7% Inpatient Death 4%
14 Palliative care admissions Admissions to palliative care (Casey) 403 admissions (2013) 13 with CCF as main diagnosis (3.2%) 29 of 1386 CCF admissions were to a palliative care unit of Monash Heath for end of life care/symptom management ie 2.1% of CCF admissions
15 End of life scenarios After Eu J Heart Failure: April 2009
16 Nurse Practitioners Nurse led community Management Regular follow up/early detection of deterioration Continued adjustment of therapy (protocol driven) Promotion and support of self-management Education(pharmacologic, non pharmacologic, exercise, nutrition) Liaison with other health carers (cardiologist/gp/others including palliative care services) Support for patient and carers Advanced care planning.
17 audit results
18
19 Prognostic tools in CCF Boyd and Murray (2010) App I Pal CCF Tool Disease related indicators e.g NYHA stage III/IV Symptoms Renal impairment Cachexia Three triggers approach The surprise question General decline Specific clinical indicators (NYHA IV) admissions
20 Prognostic tools in CCF In general these tools are good for population predictions but of limited utility in the individual.
21 Questions Questions to consider 1/in view of poor prognostication capacity when should palliative care services become involved? 2/Should Palliative Care be an integral part of the CCF multidisciplinary team(i.e. up skill the staff, expand the staff) or a separate skill silo (where?) 3/How can liaison between service providers in the community be improved?
22
1000 Lives Key Components of Reliable, Evidence-Based Chronic Heart Failure Care how do we compare?
1000 Lives Key Components of Reliable, Evidence-Based Chronic Heart Failure Care how do we compare? Dr Nerys Davies, GPST Ms B. Davies, Specialist Nurse (Heart Failure) Dr J. Taylor, Consultant Cardiologist
Evolution of Heart Failure Disease Management at a Large VA Medical Center. Richard S. Schofield MD, FACC North Florida/South Georgia VHS
Evolution of Heart Failure Disease Management at a Large VA Medical Center Richard S. Schofield MD, FACC North Florida/South Georgia VHS Disclosures None 2 1,000,000 Increasing VA Burden: Outpatient Encounters
NCAP NATIONAL CARDIAC AUDIT PROGR AMME NATIONAL HEART FAILURE AUDIT 2016/17 SUMMARY REPORT
NCAP NATIONAL CARDIAC AUDIT PROGR AMME NATIONAL HEART FAILURE AUDIT 2016/17 SUMMARY REPORT CONTENTS PATIENTS ADMITTED WITH HEART FAILURE...4 Demographics... 4 Trends in Symptoms... 4 Causes and Comorbidities
Tri-City Cardiology Consultants FIFTH ANNUAL SYMPOSIUM
Tri-City Cardiology Consultants FIFTH ANNUAL SYMPOSIUM Faculty Disclosure Banner Baywood Medical Center -Chief of Staff FIFTH ANNUAL SYMPOSIUM NYHA class III-IV symptoms Clinical signs of fluid retention
HOW TO USE THE CLINICAL PATHWAY
CONGESTIVE HEART FAILURE CLINICAL PATHWAY ACUTE STAGE HANOVER AND DISTRICT HOSPITAL 1. 2. 3. 4. INCLUSION CRITERIA Primary admitting diagnosis is Congestive Heart Failure as defined by New York Heart Association.
8. Pharmacological Management
8. Pharmacological Management Neurohormonal deactivation 1. Adrenaline Beta Blockers Dose Side Effects Monitoring Neurohormonal Deactivation 2. Angiotensin II ACE Inhibition Dose Side Effects Monitoring
Health Services Utilization and Medical Costs Among Medicare Atrial Fibrillation Patients / September 2010
Health Services Utilization and Medical Costs Among Medicare Atrial Fibrillation Patients / September 2010 AF Stat is sponsored by sanofi-aventis, U.S. LLC, which provided funding for this report. Avalere
Heart Failure (HF) - Primary Care Flow Charts. Pre diagnosis Symptoms or signs suggestive of HF
Heart Failure (HF) - Primary Care Flow Charts Pre diagnosis Symptoms or signs suggestive of HF 12 lead ECG Normal examination and 12 lead ECG HF highly unlikely Abnormal 12 lead ECG HF Possible Arrange
Heart Failure (HF) - Primary Care Flow Charts. Symptoms or signs suggestive of HF. Pre diagnosis. Refer to the Heart Failure Clinic at VHK for
Heart Failure (HF) - Primary Care Flow Charts Pre diagnosis Symptoms or signs suggestive of HF 12 lead ECG Normal examination and 12 lead ECG HF highly unlikely Abnormal 12 lead ECG HF Possible Arrange
Chronic Illness Resource Usage
Chronic Illness Resource Usage, Assoc Prof Girosi, Dr David Dean HRT 1520 Innovations Workshops and Awards 19-20 November 2015, Sydney 2 Innovation Summary Key problem: DRGs do not take into account chronic
9 Diabetes care. Back to contents
Back to contents Diabetes is a major risk factor for the development of peripheral vascular disease and 349/628 (55.6%) of the patients in this study had diabetes. Hospital inpatients with diabetes are
Specialist Palliative Care Audit and Guidelines Group (SPAGG)
Specialist Palliative Care Audit and Guidelines Group (SPAGG) Clinical Guideline for the Prescribing and Administration of Furosemide via continuous subcutaneous infusion (CSCI) for Heart Failure Patients
Asthma J45.20 Mild, uncomplicated J45.21 Mild, with (acute) exacerbation J45.22 Mild, with status asthmaticus
A Fib & Flutter I48.0 Paroxysmal atrial fibrillation I48.1 Persistent atrial fibrillation I48.2 Chronic atrial fibrillation I48.3 Typical atrial flutter Asthma J45.20 Mild, uncomplicated J45.21 Mild, with
Oxford Kidney Unit A guide to conservative kidney management. Information for Healthcare Professionals
Oxford Kidney Unit A guide to conservative kidney management Information for Healthcare Professionals What is conservative kidney management? Some people with advanced kidney disease (chronic kidney disease
Hu J, Gonsahn MD, Nerenz DR. Socioeconomic status and readmissions: evidence from an urban teaching hospital. Health Aff (Millwood). 2014;33(5).
Appendix Definitions of Index Admission and Readmission Definitions of index admission and readmission follow CMS hospital-wide all-cause unplanned readmission (HWR) measure as far as data are available.
HOW TO USE THE CLINICAL PATHWAY
1. 2. 3. 4. INCLUSION CRITERIA Primary admitting diagnosis is Congestive Heart Failure as defined by New York Heart Association. EXCLUSION CRITERIA Patients less than 19 years of age. HOW TO USE THE This
HOW TO USE THE CLINICAL PATHWAY
CONGESTIVE HEART FAILURE CLINICAL PATHWAY ACUTE STAGE GREY BRUCE HEALTH SERVICES Lion's Head Markdale Meaford Owen Sound Southampton Tobermory Wiarton 1. 2. 3. 4. INCLUSION CRITERIA EXCLUSION CRITERIA
UH Case Medical Center Adult Inpatient Telemetry Admission, Transfer and Discharge Guidelines
UH Case Medical Center Adult Inpatient Telemetry Admission, Transfer and Discharge Guidelines STATEMENT OF PURPOSE: To facilitate appropriate geo-location placement of patients who require telemetry monitoring
Appendix 1: Supplementary tables [posted as supplied by author]
![Appendix 1: Supplementary tables [posted as supplied by author]](/thumbs/81/83505567.jpg "Appendix 1: Supplementary tables [posted as supplied by author]")
Appendix 1: Supplementary tables [posted as supplied by author] Table A. International Classification of Diseases, Ninth Revision, Clinical Modification Codes Used to Define Heart Failure, Acute Myocardial
Heart Failure: Guideline-Directed Management and Therapy
Heart Failure: Guideline-Directed Management and Therapy Guideline-Directed Management and Therapy (GDMT) was developed by the American College of Cardiology and American Heart Association to define the
Heart Failure. GP Update Refresher 18 th January 2018
GP Update Refresher 18 th January 2018 Heart Failure Dr. Alexander Lyon Senior Lecturer and Consultant Cardiologist Clinical Lead in Cardio-Oncology Royal Brompton Hospital, London UK President of British
CLINICAL PROCESS IMPROVEMENT INITIATIVE (CPII) EFFICIENCY REPORT EXPLANATION January 4, 2016
CLINICAL PROCESS IMPROVEMENT INITIATIVE (CPII) EFFICIENCY REPORT EXPLANATION January 4, 2016 WHAT IS AN EPISODE OF CARE? An episode of care is a grouping of a patient s health care claims for a unique
Preoperative tests (update)
National Institute for Health and Care Excellence. Preoperative tests (update) Routine preoperative tests for elective surgery NICE guideline NG45 Appendix N: Research recommendations April 2016 Developed
Self-assessment checklist
Self-assessment checklist 1 1 All hospitals should have a fully staffed diabetes inpatient team, made up of the following 1 : consultant. Sufficient diabetes inpatient specialist nurses to run a daily
Hospital at Home. Frailty and Hospital at Home. 17 th March Pam Livingstone and Gwyneth Thom
Hospital at Home Frailty and Hospital at Home 17 th March 2016 Pam Livingstone and Gwyneth Thom National Definition of Hospital at Home December 2013 An episode of specialist care delivered at home as
PRE Operative Care of the High Risk Surgical Patient. Dr A T Dewhurst Consultant Anaesthetist St George s Hospital London
PRE Operative Care of the High Risk Surgical Patient Dr A T Dewhurst Consultant Anaesthetist St George s Hospital London Perioperative Optimization Shoemaker oxygen delivery goal directed therapy ITS NOT
Dr Conor Maguire Consultant, NHS Lothian Chair, Lothian Parkinson s Forum
Dr Conor Maguire Consultant, NHS Lothian Chair, Lothian Parkinson s Forum I am a GERIATRICIAN Training: General Medicine Neurological conditions Cognition memory clinics Falls Multi-organ involvement of
NQF-ENDORSED VOLUNTARY CONSENSUS STANDARD FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Outcome Measures (Claims Based)
Last Updated: Version 4.3 NQF-ENDORSED VOLUNTARY CONSENSUS STANDARD FOR HOSPITAL CARE Measure Information Form Collected For: CMS Outcome Measures (Claims Based) Measure Set: CMS Readmission Measures Set
National Landscape of Hospital-Based Palliative Care: Findings from the National Palliative Care Registry
National Landscape of Hospital-Based Palliative Care: Findings from the National Palliative Care Registry Maggie Rogers, MPH Senior Research Associate, CAPC Tamara Dumanovsky, PhD VP Research & Analytics,
Alister Jones Patient Blood Management Practitioner NHS Blood and Transplant
Alister Jones Patient Blood Management Practitioner NHS Blood and Transplant All medical RCC transfusions (but only 1 in 3 haematology or oncology cases) in 3 x one week periods Medical specialties include:
Arkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary
Arkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary Congestive Heart Failure Algorithm Summary v1.2 (1/5) Triggers PAP assignment Exclusions Episode time window
Supplementary Online Content
Supplementary Online Content Dharmarajan K, Wang Y, Lin Z, et al. Association of changing hospital readmission rates with mortality rates after hospital discharge. JAMA. doi:10.1001/jama.2017.8444 etable
NCEPOD - Measuring the Units; A review of patients who died with alcohol-related liver disease
NCEPOD - Measuring the Units; A review of patients who died with alcohol-related liver disease Hospital Number Admission to hospital 5. Trusts should ensure that medical patients are reviewed by a consultant
Shared Care Guideline Metolazone for fluid management in CKD (Adults)
Shared Care Guideline Metolazone for fluid management in CKD (Adults) It is vital for safe and appropriate patient care that there is a clear understanding of where clinical and prescribing responsibility
The Cost Burden of Worsening Heart Failure in the Medicare Fee For Service Population: An Actuarial Analysis
Client Report Milliman Client Report The Cost Burden of Worsening Heart Failure in the Medicare Fee For Service Population: An Actuarial Analysis Prepared by Kathryn Fitch, RN, MEd Principal and Healthcare
The following content was supplied by the author as supporting material and has not been copy-edited or verified by JBJS.
Page 1 The following content was supplied by the author as supporting material and has not been copy-edited or verified by JBJS. Appendix TABLE E-1 Care-Module Trigger Events That May Indicate an Adverse
Community and Mental Health Services. Palliative Care. Criteria and
Community and Mental Health Services Specialist Palliative Care Service Referral Criteria and Guidance November 2018 Specialist Palliative Care Service Referrals These guidelines cover referrals for patients
Walking together: Palliative Care and heart failure.
Walking together: Palliative Care and heart failure. St Paul's Hospital Heart Function Supportive Care Clinic Cindy Nordquist MN-NP(F) Objectives Review heart failure. Review palliative care/ palliative
Maryland Patient Safety Center s Annual MEDSAFE Conference: Taking Charge of Your Medication Safety Challenges November 3, 2011 The Conference Center
Maryland Patient Safety Center s Annual MEDSAFE Conference: Taking Charge of Your Medication Safety Challenges November 3, 2011 The Conference Center at the Maritime Institute Pharmacy-Driven Inpatient
Potentially Preventable Hospitalizations
Potentially Preventable Hospitalizations What does kidney disease have to do with it? Elaine Braslow, MEd September 29, 2015 About your kidneys What do the kidneys do? Prevent buildup of wastes and extra
APPENDIX EXHIBITS. Appendix Exhibit A2: Patient Comorbidity Codes Used To Risk- Standardize Hospital Mortality and Readmission Rates page 10
Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand ST, et al. Based on key measures, care quality for Medicare enrollees at safety-net and non-safety-net hospitals was almost equal. Health Aff (Millwood).
The Future of Cardiac Care: Managing Our Patients Together
The Future of Cardiac Care: Managing Our Patients Together Charles R. Caldwell, MD, FACC Disclosures: iheartdoc,inc. Telemedicine 1 MACRA Medicare Access and CHIP Reauthorization Act of 2015 Repealed the
Acute Kidney Injury 2
South West Cardiovascular Strategic Clinical Network Acute Kidney Injury 2 Audit review meeting 18/07/2014 Redwood Education Centre Author: Summary of results: Dr Preetham Boddana Consultant Nephrologist
Policy Brief June 2014
Policy Brief June 2014 Which Medicare Patients Are Transferred from Rural Emergency Departments? Michelle Casey MS, Jeffrey McCullough PhD, and Robert Kreiger PhD Key Findings Among Medicare beneficiaries
Quality Outcomes and Financial Benefits of Nutrition Intervention. Tracy R. Smith, PhD, RD, LD Senior Clinical Manager, Abbott Nutrition
Quality Outcomes and Financial Benefits of Nutrition Intervention Tracy R. Smith, PhD, RD, LD Senior Clinical Manager, Abbott Nutrition January 28, 2016 SHIFTING MARKET DYNAMICS PROVIDE AN OPPORTUNITY
URN: Family name: Given name(s): Address: Initial Signature Print Name Role
Do Not Write in this binding margin v5.00-02/2012 Mat. No.: 10206019 SW030b The State of Queensland (Queensland Health) 2012 Contact CIM@health.qld.gov.au ÌSW030bIÎ Facility: s Never Replace Clinical Judgement
Rehabilitation - Reducing costs and hospital stay. Dr Elizabeth Aitken Consultant Physician
Rehabilitation - Reducing costs and hospital stay Dr Elizabeth Aitken Consultant Physician What factors affect outcome? Comorbidities Cardiac Respiratory Neurological Nutritional issues Diabetes Anaemia
Understanding Parkinson s for health and social care staff. The phases of Parkinson s
Understanding for health and social care staff The phases of The phases of Diagnosis 11% 1.6 Post diagnosis before symptoms have become significant Maintenance 40.4% 5.9 Symptoms significant but largely
BPCI Advanced Episode Selection
BPCI Advanced Episode Selection Analytic Framework and Strategies from Northwestern Medicine Presented June 7, 2018 to: Insert relevant presenter information Calibri 16pt Presented Jessica Walradt on:
Specialist Palliative Care Service Referral Criteria and Guidance
Specialist Palliative Care Service Referral Criteria and Guidance Specialist Palliative Care Service Referrals These guidelines cover referrals for patients with progressive terminal illness, whether
Chronic heart failure in adults: diagnosis and management
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Chronic heart failure in adults: diagnosis and management NICE guideline: short version Draft for consultation, March 0 This guideline covers diagnosing
LCD L B-type Natriuretic Peptide (BNP) Assays
LCD L30559 - B-type Natriuretic Peptide (BNP) Assays Contractor Information Contractor Name: Novitas Solutions, Inc. Contractor Number(s): 12501, 12502, 12101, 12102, 12201, 12202, 12301, 12302, 12401,
Heart Failure and Palliative Care making a difference?
Heart Failure and Palliative Care making a difference? Miriam Johnson Wolfson Palliative Care Research Centre University of Hull Saint Catherine's, Scarborough Overview Just to recap What s so difficult?
New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0.
New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0. Measure Steward Measure Name Measure Description Rationale for Adding
Program Metrics. New Unique ID. Old Unique ID. Metric Set Metric Name Description. Old Metric Name
Program Metrics The list below includes the metrics that will be calculated by the PINNACLE Registry for the outpatient office setting. These include metrics for, Atrial Fibrillation, Hypertension and.
Specialist Palliative Care Referral for Patients
Specialist Palliative Care Referral for Patients This guideline covers referrals for patients with progressive terminal illness, whether due to cancer or other disease. For many patients in the late stages
Why is co-morbidity important for cancer patients? Michael Chapman Research Programme Manager
Why is co-morbidity important for cancer patients? Michael Chapman Research Programme Manager Co-morbidity in cancer Definition:- Co-morbidity is a disease or illness affecting a cancer patient in addition
Heart failure hospitalizations with preserved or reduced ejection fraction
Clinical profile and in-hospital outcomes in patients admitted for heart failure with preserved or reduced ejection fraction. EPI-CARDIO prospective registry Tajer, C; Mariani, J; de Abreu, M; Charask,
Road Blocks in Non-Cancer Palliative Care Obstacles observed from outpatient non-cancer palliative practice.
Road Blocks in Non-Cancer Palliative Care Obstacles observed from outpatient non-cancer palliative practice. 25th Annual Palliative Education and Research Days, West Edmonton Mall. Edmonton. 2014 Amanda
Performance and Quality Measures 1. NQF Measure Number. Coronary Artery Disease Measure Set
Unless indicated, the PINNACLE Registry measures are endorsed by the American College of Cardiology Foundation and the American Heart Association and may be used for purposes of health care insurance payer
A Global perspective on Heart Failure: What needs to change? Martin R Cowie London, United Kingdom
A Global perspective on Heart Failure: What needs to change? Martin R Cowie London, United Kingdom Global perspective on heart failure: what needs to change? Martin R Cowie Professor of Cardiology National
New NICE Heart Failure Guidelines What do they mean for primary and secondary care, and patients?
New NICE Heart Failure Guidelines 2018 - What do they mean for primary and secondary care, and patients? Prof Ahmet Fuat PhD FRCGP FRCP PG Dip (Cardiology) GP & GPSI Cardiology Darlington Professor of
CLINICAL PRACTICE GUIDELINE
CLINICAL PRACTICE GUIDELINE Procedure: Congestive Heart Failure Guideline Review Cycle: Biennial Reviewed By: Amish Purohit, MD, MHA, CPE, FACHE Review Date: November 2014 Committee Approval Date: 11/12/2014
PALLIATIVE CARE FOR PATIENTS AND FAMILIES LIVING WITH CKD AND ESRD
PALLIATIVE CARE FOR PATIENTS AND FAMILIES LIVING WITH CKD AND ESRD Karen Solcher, MSN, APRN, NP-C, CNN-NP Nephrology Nurse Practitioner Stormont-Vail Health DISCLAIMER Adult population Clinical practice
Objectives. Medicare Spending per Beneficiary: Analyzing MSPB Data to Identify Primary Drivers
Medicare Spending per Beneficiary: Analyzing MSPB Data to Identify Primary Drivers August 22, 2017 Objectives Understand the basics of the hospital specific MSPB data files and reports Review the factors
Aged Care and Health Services Research. A/Prof Kwang Lim Sep 2016
Aged Care and Health Services Research A/Prof Kwang Lim Sep 2016 Accumulating evidence 20% of health care interventions is based on hard evidence. Feasibility of doing randomised controlled trials on all
Center for Respiratory and Sleep Medicine COPD Chronic Disease Management Program
Center for Respiratory and Sleep Medicine COPD Chronic Disease Management Program Cristina Ashworth, NP Khalil Diab,MD Center for Respiratory and Sleep Medicine Subgroup of Indiana Internal Medicine Consultants
Diabetes (DIA) Measures Document
Diabetes (DIA) Measures Document DIA Version: 2.1 - covering patients discharged between 01/07/2016 and present. Programme Lead: Liz Kanwar Clinical Lead: Dr Aftab Ahmad Number of Measures In Clinical
Heart Failure Vital steps for palliative care. Dr Karen J Hogg Glasgow Royal Infirmary
Heart Failure Vital steps for palliative care Dr Karen J Hogg Glasgow Royal Infirmary Overview Why is heart failure a problem? Why do we need integrated cardiology and palliative care services? Cardiology
Referral for Heart Transplantation - who and when?
Transplant Referral for heart transplantation - who and when Sarah Fitzsimons Chairs: Kathy Ferrier & Richard Troughton Referral for Heart Transplantation - who and when? CSANZ June 2018 1 Introduction
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Medical technology guidance FINAL SCOPE ENDURALIFE-powered CRT-D devices for the treatment of heart failure 1 Technology 1.1 Description of the technology
There Is Something More We Can Do: An Introduction to Hospice and Palliative Care
There Is Something More We Can Do: An Introduction to Hospice and Palliative Care presented to the Washington Patient Safety Coalition July 28, 2010 Hope Wechkin, MD Medical Director Evergreen Hospice
Chronic Kidney Disease (CKD) in the Darling Downs- a Registry report
DDHHS Chronic Kidney Disease (CKD) in the Darling Downs- a Registry report Sree K Venuthurupalli MD, DM, FRACP Consultant Nephrologist-Toowoomba Hospital Darling Downs Hospital and Health Service-DDHHS
Geriatric Medicine I) OBJECTIVES
Geriatric Medicine I) OBJECTIVES 1 To provide a broad training and in-depth experience at a level sufficient for trainees to acquire competence and professionalism required of a specialist in Geriatric
PREOPERATIVE ANAEMIA PATHWAY
PREOPERATIVE ANAEMIA PATHWAY Surname: Unit No. Forename: DOB: / / Age: NHS Number: Likes to be called: Address: Tel. No. Religion/Spirituality: GP Name: GP Practice: Planned Operation: Postcode: Mobile
Summary of Research and Writing Activities In Cardiovascular Disease
Summary of Research and Writing Activities In Cardiovascular Disease Carole Alison Chrvala, PhD 919.545.2149 (Work) 919.951.5230 (Mobile) cchrvala@centurylink.net www.healthmattersmedwriting.com 1 Manuscripts
Palliative Care in Advanced CHF. Dina R. Yazmajian, MD Division of Cardiology Division of Palliative Care
Palliative Care in Advanced CHF Dina R. Yazmajian, MD Division of Cardiology Division of Palliative Care Required Disclosure Slide I have no financial or commercial interests which could result in any
Target Weight at the Center of Heart Failure. April 24, 2018
Target Weight at the Center of Heart Failure April 24, 2018 Disclosures None 2 Our Mission and Vision 3 Acute Heart Failure Gradual or rapid change in HF symptoms resulting in a need for urgent therapy
HEART FAILURE QUALITY IMPROVEMENT. American Heart Association Shawni Smith Regional Director, Quality & Systems Improvement
HEART FAILURE QUALITY IMPROVEMENT American Heart Association Shawni Smith Regional Director, Quality & Systems Improvement 1 DISCLOSURES NONE 2 3 WHY IS THIS IMPORTANT? WHY? Heart Failure Currently, an
The National Heart Failure Audit 2010/2011
The National Heart Failure Audit 2010/2011 Project Steering Group; TA McDonagh, JG Cleland, HJ Dargie, S Hardman,P Mitchell, A Cunningham 85% NHS Trusts submitting data (133/156) 36,504 admissions 70%
Heart Failure Acute and Chronic
Heart Failure Acute and Chronic Cardiac Services in Wales Acute Heart Failure standards Chronic Heart Failure standards NWIS admissions/readmission data NHFA data 2016-17 Echo accessibility BNP availability
HOSPITAL MEDICINE BECOMING A PHYSICIAN
HOSPITAL MEDICINE BECOMING A PHYSICIAN DR MIKE MASDING Consultant Physician & Diabetologist Poole Hospital NHS Foundation Trust 24 September 2010 Hospital Medicine Becoming a Physician What is a Physician?
CARDIOLOGY GRAND ROUNDS
CARDIOLOGY GRAND ROUNDS Presentation: Date: Location: Speaker: ACC 2015 PREVIEW Monday, March 9, 2015, 7:00 8:00 AM ANW Education Building, Watson Room Elevated Troponin in Patients Presenting to the Emergency
Palliative Care Quality Improvement Program (QIP) Measurement Specifications
Palliative Care Quality Improvement Program (QIP) 2017-18 Measurement Specifications Developed by: QIP Team Contact: palliativeqip@partnershiphp.org Published on: October 6, 2017 Table of Contents Program
Risk Adjustment and Hierarchical Condition Category Coding
Risk Adjustment 101 Agenda Risk Adjustment Model Hierarchical Condition Categories (HCC) Patient Example Documentation MEAT Documentation Guidance Chronic Conditions Risk Score Calculations Steps for Physician
Information Management. A System We Can Count On. Chronic Conditions. in the Central East LHIN
Information Management A System We Can Count On Chronic Conditions in the Central East LHIN Health System Intelligence Project October 2007 Table of Contents About HSIP..................................ii
London Strategic Clinical Networks. Quality Standard. Version 1.0 (2015)
London Strategic Clinical Networks Quality Standard Version 1.0 (2015) Supporting the delivery of equitable, high quality AKI care through collaboration www.londonaki.net @LondonAKI Overview The management
Care of the Elderly 1
Care of the Elderly 1 Contents Summary... 3 Introduction... 4 National Trends 4 Older people's Care in Dumfries & Galloway... 6 Professional Body Recommendation 11 Experience from elsewhere..12 Models
The role of internist in heart failure management bridging the quality gaps
The role of internist in heart failure management bridging the quality gaps Mohammad AlQahtani.MD,FACP Associate professor and head of internal medicine, KSAU-HS/KAMC Consultant internal medicine/hf Deputy
Professional Development Presents. May 2016 Medication of the Month. Milrinone Drip IN2731
Med of the Month For any question regarding May 2016 Med of the Month: Milrinone Drip You may contact: Sherr Ann Arabit MSN, RN-BC, CCRN/Professional Development Department Ext 4196 Professional Development
Evaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF<40%
Evaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF
Enhancing the Quality of Heart Failure Care
Enhancing the Quality of Heart Failure Care 2 Enhancing the quality of Heart Failure care Kent Surrey Sussex Academic Health Science Network 3 Contents 2 Heart failure care in the UK: Case for change 3
Mental Health in STH Mike Richmond, Medical Director Mark Cobb, Clinical Director of Professional Services Debate & Note
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY REPORT TO THE TRUST HEALTHCARE GOVERNANCE COMMITTEE E TO BE HELD ON 27 FEBRUARY 2012 Subject: Supporting Director: Author: Status 1 Mental
TN Bundled Payment Initiative: Overview of Episode Risk Adjustment
TN Bundled Payment Initiative: Overview of Episode Risk Adjustment United Healthcare, April 2014 The State of Tennessee has implemented an episode-based approach to reimburse providers for the care delivered
Sentinel Stroke National Audit Programme (SSNAP)
Sentinel Stroke National Audit Programme (SSNAP) Changes over Time: 4 years of data April 2013 March 2017 National results Based on stroke patients admitted to and/or discharged from hospital between April
HEART FAILURE. Study day November 2017 Sarah Briggs and Janet Laing
HEART FAILURE Study day November 2017 Sarah Briggs and Janet Laing Overview and Introduction This course is an introduction and overview of heart failure. Normal heart function and basic pathophysiology
Supplementary Online Content
Supplementary Online Content Toyoda N, Chikwe J, Itagaki S, Gelijns AC, Adams DH, Egorova N. Trends in infective endocarditis in California and New York State, 1998-2013. JAMA. doi:10.1001/jama.2017.4287
Hospice Eligibility August 2018
Hospice Eligibility August 2018 Objectives Identify who can make a hospice referral Review hospice eligibility and disease-specific prognostic indicators Review Open Access philosophy Who Can Make A Referral
Summary/Key Points Introduction
Summary/Key Points Introduction Scope of Heart Failure (HF) o 6.5 million Americans 20 years of age have HF o 960,000 new cases of HF diagnosed annually o 5-year survival rate for HF is ~50% Classification