Table 21-2.

HF Quality-of-Care Measures, 2010

Quality-of-Care Measure	National Data From HIQR Program*	AHA GWTG-HF	VHA
LVEF assessment	97.8	98†	100
ARB/ACEI at discharge for patients with LVSD	94.7	94.2†	96
Complete discharge instructions	88.9	93.3†	97
Adult smoking cessation advice/counseling	98.5	99.3†	99
β-blockers at discharge for patients with LVSD, no contraindications	NM	94.8†	NM
Anticoagulation for AF or atrial flutter, no contraindications	NM	70.2	95

HF indicates heart failure; HIQR, Hospital Inpatient Quality Reporting; AHA GWTG-HF, American Heart Association’s Get With The Guidelines–Heart Failure; VHA, Veterans Health Administration; LVEF, left ventricular ejection fraction; ARB/ACEI, angiotensin receptor blocker/angiotensin-converting enzyme inhibitor; LVSD, left ventricular systolic dysfunction; NM, not measured; and AF, atrial fibrillation.

Values are percentages.

In the GWTG registry, mechanical ventilation was required in 3.0% of patients. In-hospital mortality rate was 3.0%, and mean length of hospital stay was 5.5 days (median 4.0 days).

^*HIQR Program includes data from all payers, including Medicare and Medicaid.

^†Indicates the 5 key performance measures targeted in GWTG-HF. The composite quality-of-care measure for 2010 was 95.7%. The composite quality-of-care measure indicates performance on the provision of several elements of care. It is computed by summing the numerators for each key performance measure across the population of interest to create a composite numerator (all the care that was given), summing the denominators for each measure to form a composite denominator (all the care that should have been given), and reporting the ratio (the percentage of all the needed care that was given).