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Quality of care reviews for congestive heart failure and acute myocardial infarction at Jefferson General Hospital: A randomized, retrospective chart review for 2002

1 August 2003


As medicine and the standard of care change, clinicians must change their practice. Centers for Medicare and Medicaid Services (CMS) is conducting a national study involving 22 quality indicators, 4 of which regard Heart Failure treatment and 8 of which address Acute Myocardial Infarction treatment. This study is a retrospective chart review to assess how well Jefferson General Hospital, in Port Townsend, WA, adheres to the CMS Heart Failure and Acute Myocardial Infarction quality indicators. Random samples of charts from patients hospitalized in 2002 with primary diagnoses of Congestive Heart Failure or Acute Myocardial Infarction were surveyed. Results were calculated as the percentage of patients with no contraindications, who received the specified treatment. Discharge prescriptions and instructions were calculated for patients discharged to home or nursing home, not for those transferred to a different short-term care facility. Results varied widely for the different indicators. For Congestive Heart Failure patients: Left ventricular function was evaluated 50% of the time; ACE Inhibitor was prescribed for patients with ejection fraction130 mg/dL was treated 25% of the time. Recommendations were made to Jefferson General Hospital based on these results. This 2002 sample will be used as the baseline for a 2003 comprehensive chart review addressing the same Quality Improvement Indicators.


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