Release Notes:
Measure Information Form
Version 2010B
**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**Measure Information Form
Measure Set: Heart Failure (HF)
Set Measure ID: HF-2
Performance Measure Name: Evaluation of LVS Function
Description: Heart failure patients with documentation in the hospital record that left ventricular systolic (LVS) function was evaluated before arrival, during hospitalization, or is planned for after discharge
Rationale: Appropriate selection of medications to reduce morbidity and mortality in heart failure requires the identification of patients with impaired left ventricular systolic function. National guidelines advocate the evaluation of left ventricular systolic function as the single most important diagnostic test in the management of all patients with heart failure (Hunt, 2005). Despite these recommendations, left ventricular systolic function is not evaluated in a substantial proportion of eligible older patients hospitalized with heart failure (Jencks, 2000).
Type of Measure: Process
Improvement Noted As: Increase in the rate
Numerator Statement: Heart failure patients with documentation in the hospital record that LVS function was evaluated before arrival, during hospitalization, or is planned for after discharge
Included Populations: Not applicable
Excluded Populations: None
Data Elements:
Denominator Statement: Heart failure patients
Included Populations:
- Discharges with an ICD-9-CM Principal Diagnosis Code for heart failure as defined in Appendix A, Table 2.1
Excluded Populations:
- Patients who had a left ventricular assistive device (LVAD) or heart transplant procedure during hospital stay (ICD-9-CM procedure code for LVAD and heart transplant as defined in Appendix A, Table 2.2)
- Patients less than 18 years of age
- Patients who have a Length of Stay >120 days
- Patients enrolled in clinical trials
- Patients discharged/transferred to another hospital for inpatient care
- Patients who left against medical advice or discontinued care
- Patients who expired
- Patients discharged/transferred to a federal health care facility
- Patients discharged/transferred to hospice
- Patients with Comfort Measures Only documented
- Patients with reasons documented by a physician/advanced practice nurse/physician assistant for no LVS function evaluation
Data Elements:
Continuous Variable Statement:
Included Populations:
Excluded Populations:
Data Elements:
Risk Adjustment: No.
Data Collection Approach: Retrospective data sources for required data elements include administrative data and medical records.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: None
Sampling: Yes. For additional information see the Sampling Section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
- Bonow RO, Bennett S, Casey DE, Ganiats TG, Hlatky MA, Konstam MA, Lambrew CT, Normand ST, Piña IL, Radford MJ, Smith AL, Stevenson L. ACC/AHA Clinical Performance Measures for Adults With Chronic Heart Failure: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Heart Failure Clinical Performance Measures). J Am Coll Cardiol 2005;46:1144–78. Available at http://www.acc.org and http://www.americanheart.org.
- Heart Failure Society of America. HFSA 2006 Comprehensive Heart Failure Practice Guideline. J Card Fail. 2006 Feb;12(1):e1-2.
- Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005; 46(6):e1-82.
- Jencks SJ, Cuerdon T, Burwen DR, Fleming B, Houck PM, Kussmaul AE, Nilasena DS, Ordin DL, Arday DR. Quality of medical care delivered to Medicare beneficiaries: a profile at state and national levels. JAMA. 2000;284:1670-1676.
Measure Algorithm:
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