Table 22-4.
Time Trends in GWTG-HF Quality-of-Care Measures, 2006 to 2012
| Quality-of-Care Measure | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 |
|---|---|---|---|---|---|---|---|
| LVEF assessment* | 93.8 | 96.2 | 96.8 | 98.2 | 98 | 99.2 | 96.5 |
| ARB/ACEI at discharge for patients with LVSD* | 85.5 | 89.1 | 91.6 | 93.0 | 94.2 | 95.4 | 95.4 |
| Complete discharge instructions† | 78.8 | 84.8 | 88.5 | 90.9 | 93.3 | 93.5 | 93.4 |
| Postdischarge appointment (new for 2011)* | … | … | … | … | … | 13.3 | 47.4 |
| Adult smoking cessation advice/counseling† | 90.8 | 94.7 | 97.1 | 97.6 | 99.3 | 99.2 | 97.3 |
| β-Blockers at discharge for patients with LVSD, no contraindications† | 89.9 | 90.2 | 92.5 | 92.7 | 94.8 | 96.2 | 97.2 |
| Evidence-based specific β-blockers* | 67.7 | 58.9 | 54.1 | 45.2 | 48.4 | 58.4 | 82.6 |
| Anticoagulation for AF or atrial flutter, no contraindications | 62.9 | 61.6 | 60.7 | 68.9 | 70.2 | 75.4 | 78.7 |
Values are percentages.
In the GWTG registry, mechanical ventilation was required in 0.9% of patients. In-hospital mortality was 2.5%, and mean length of hospital stay was 5.0 d (median 4.0 d).
AF indicates atrial fibrillation; ARB/ACEI, angiotensin receptor blocker/angiotensin-converting enzyme inhibitor; GWTG-HF, Get With The Guidelines–Heart Failure; LVEF, left ventricular ejection fraction; and LVSD, left ventricular systolic dysfunction.
Indicates the 4 key achievement measures targeted in GWTG-HF. The composite quality-of-care measure for 2012 was 93.5%. 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 achievement 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). The composite performance measure includes β-blocker at discharge instead of evidence-based specific β-blockers and complete discharge instructions instead of postdischarge appointment until data collection for the new achievement measures stabilizes.
Indicates historical key achievement measures in GWTG-HF. The composite quality-of-care measure for 2012 for the historical key achievement measures was 64.9%.