Table 21-4.

Time Trends in GWTG-HF Quality-of-Care Measures, 2006–2011

Quality-of-Care Measure	2006	2007	2008	2009	2010	2011
LVEF assessment*	93.8	96.2	96.8	98.2	98	99.2
ARB/ACEI at discharge for patients with LVSD*	85.5	89.1	91.6	93.0	94.2	95.4
Complete discharge instructions†	78.8	84.8	88.5	90.9	93.3	93.5
Postdischarge appointment (new for 2011)*	…	…	…	…	…	13.3
Adult smoking cessation advice/counseling†	90.8	94.7	97.1	97.6	99.3	99.2
β-Blockers at discharge for patients with LVSD, no contraindications†	89.9	90.2	92.5	92.7	94.8	96.2
Evidence-based specific β-blockers*	67.7	58.9	54.1	45.2	48.4	58.4
Anticoagulation for atrial fibrillation or atrial flutter, no contraindications	62.9	61.6	60.7	68.9	70.2	75.4

Values are percentages.

In the GWTG registry, mechanical ventilation was required in 1.1% of patients. In-hospital mortality was 3.4%, and mean length of hospital stay was 5.7 days (median 4.0 days).

GWTG-HF indicates Get With The Guidelines–Heart Failure; LVEF, left ventricular ejection fraction; ARB/ACEI, angiotensin receptor blocker/angiotensin-converting enzyme inhibitor; and LVSD, left ventricular systolic dysfunction.

^*Indicates the 4 key achievement measures targeted in GWTG-HF. The composite quality-of-care measure for 2011 was 57.6%. 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).

^†Indicates historical key achievement measures in GWTG-HF. The composite quality-of-care measure for 2011 for the historical key achievement measures was 82.3%.