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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-4

Performance Measure Name: Adult Smoking Cessation Advice/Counseling

Description: Heart failure patients with a history of smoking cigarettes, who are given smoking cessation advice or counseling during hospital stay. For purposes of this measure, a smoker is defined as someone who has smoked cigarettes anytime during the year prior to hospital arrival.

Rationale: Smoking cessation reduces mortality and morbidity in all populations. Patients who receive even brief smoking-cessation advice from their care providers are more likely to quit. National guidelines strongly recommend smoking cessation counseling for smokers with cardiovascular disease, including heart failure (Fiore, 2000; and Hunt, 2005). Despite this recommendation, smoking cessation counseling is rarely provided to eligible older patients hospitalized with heart failure (CMS National Heart Failure Project baseline data).

Type of Measure: Process

Improvement Noted As: Increase in the rate

Numerator Statement: Heart failure patients (cigarette smokers) who receive smoking cessation advice or counseling during the hospital stay
Included Populations: Not applicable

Excluded Populations: None

Data Elements:

Denominator Statement: Heart failure patients with a history of smoking cigarettes anytime during the year prior to hospital arrival

Included Populations: Discharges with:
  • An ICD-9-CM Principal Diagnosis Code for heart failure as defined in Appendix A, Table 2.1
    AND
  • A history of smoking cigarettes anytime during the year prior to hospital arrival

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

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.
  • Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. June 2000.
  • 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.

Measure Algorithm:

Attach file

Related Topics

Measure Information Form HF-4
Specifications Manual for Joint Commission National Quality Core Measures (2010B)
Discharges 10-01-10 (4Q10) through 03-31-11 (1Q11)