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:
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.
- 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:
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