Description

To improve care being given to the Heart Failure population at our facility a multidisciplinary committee was formed to review how we were meeting the guidelines for best care provided to this population and methods to improve care. Palliative care was included on this committee which offered the opportunity to increase palliative consultations for heart failure patients. The option for a palliative care consult was placed on the heart failure order set in March 2007. While this did increase the number of referrals for that population, consults to hospice and completion of Advance Directives there was still an opportunity to improve upon the process. In September 2009 the order set was changed making the palliative consultation an automatic consult with the use of the order set. Criteria also set in place to identify those patients that would be end stage: a) LVEF less than 20% or b) documentation of NYHA Class IV or AHA/ACC Stage D. Changing this consult to an automatic consult did increase referrals by 5% to this population providing an opportunity to better meet their needs for quality life. Within the next year the Heart Failure Steering committee identified an opportunity for improvement by modifying this criteria to also include patients that 3 or more multiple major co morbid conditions (CAD, OSA, HTN, Diabetes, COPD).