Heart Failure Care


Is your hospital one of the many which fall short in providing the correct care for heart failure, and are as a result putting patients at risk for dying unnecessarily?  You’d think if you go to an accredited hospital, you would get the standard of care, especially when it comes to heart failure treatment, one of the most common reasons for hospital admission.


Unfortunately, some hospitals meet expectations, and some are a surprising disappointment.


“Patients with heart failure have a pretty complicated disease, typically on at least an average of 5-7 medications.  So it’s quite paramount the discharge summary from the hospital should include those parameters to know who to follow up with what medications to take, what kind of lifestyle to pursue,” says Dr. Justine Lachmann, Director of the Congestive Heart Failure Program at St. Francis Heart Hospital.


Sounds simple enough.

But according to new research, whether a patient makes it out of the hospital alive after being treated for heart failure depends on where that person is hospitalized.


UCLA researchers analyzed admission data from more than 200 hospitals nationwide, and looked at whether they performed four basic and important measures in heart failure treatment.  One of these: prescribing a drug in the class of blood pressure medicines called ace-inhibitors—missed in 28 percent of patients.


"Without a doubt I believe that number is too low. Time and time a gain ace-inhibitors have been shown in multiple large scale clinical trials to not only decrease hospitalizations but also to save lives," Dr. Lachmann states.


And giving the patient or caregiver written instructions on post discharge care was not done in three of every four patients!  “To educate the patients is the best we can do in order to prevent the statistics that we have about re-hospitalization the high mortality rates,” says Dr. Lachmann.


In the poorest performing hospital, less than one percent of patients got discharge information.  57 percent of patient didn’t get counseling on the importance of smoking cessation.  And evaluating the pumping function of the heart’s main chamber, the left ventricle, was missed in 14 percent of patients.


The gaps were seen across the board, in large and small, teaching and non-teaching hospitals, and in all regions of the country.


The net effect was huge: a fourfold different in mortality rates between the worst and best performing hospitals.


64 year old James Appello says it’s been a 180 in terms of where he was with his health.   “I feel 100 percent better,” he exclaims. 


He attributes the focused and detailed care he got here at st. Francis heart hospital.  “I was given written discharge instructions about which medication I was to take, things I was to do things I was to avoid doing,”


It's the simple things that could mean the difference between life and death in those with heart disease.


The study is published in the latest Archives of Internal Medicine.


The U.S. Department of Health and Human Services now provides a website called "Hospital Compare" where patients can check each hospital for their performance on quality measures for heart failure and other conditions: http://www.hospitalcompare.hhs.gov/