Heart Failure

Heart failure is a condition in which the heart cannot pump sufficient blood to meet the body's nutrition and oxygen needs. Treatment of heart failure involves careful monitoring, use of proper medications and lifestyle changes.

At the University of Michigan Health System, we evaluate our performance in caring for heart failure patients by measuring the extent to which we follow best practices and achieve the best results. We are reaching and at times exceeding our quality goals for care we deliver in both the inpatient (hospital) and outpatient (physician office) settings.

The graphs below describe the quality of care that heart failure patients receive when they are hospitalized. They demonstrate that the University of Michigan Health System provides excellent quality of care across most measures and that we are working to achieve the best possible performance.

Medication Use - Ace Inhibitor and ARB
Higher Value = Better Performance

Details

Why is This Measure Important?

Patients with heart failure typically suffer from decreased function of the left side of the heart, which pumps blood to the rest of the body. Patients with heart failure are prescribed medications to make it easier for the heart to pump blood. Angiotensin-converting enzyme (ACE) inhibitors widen blood vessels, easing blood flow and decreasing the workload on the heart. These drugs help heart failure patients live longer. Angiotensin II receptor blockers (ARBs) serve as an alternative for people who cannot tolerate ACE inhibitors. This is a measure of the percentage of heart failure patients who receive a prescription for an ACE inhibitor or ARB before they leave the hospital. A higher percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System has performed better than the national average. Our most recent results show that 100% of heart failure patients received a prescription for an ACE inhibitor or ARB medication before hospital discharge.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source:National average from CMS / Hospital Compare.

Assessment of Heart Pumping Strength
Higher Value = Better Performance

Details

Why is This Measure Important?

This measure is also called “evaluation of left ventricular systolic function”. The left ventricle of the heart is the chamber the pumps blood to the rest of the body. Evaluation of left ventricular function is important for people with heart failure. This is a measure of the percentage of heart failure patients with a documented evaluation of left ventricular function or heart pumping strength. A higher percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System has consistently achieved a 100% score; an evaluation of left ventricular systolic function is completed for all heart failure patients.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

Heart Failure Survival

Details

Why is This Measure Important?

This measure evaluates the survival of heart failure patients who are hospitalized at the University of Michigan Health System. It is important to keep in mind that our health system treats some of the most severely ill heart failure patients, which makes our survival rates difficult to compare to that of other hospitals which treat heart failure patients who are not as ill. Although Medicare adjusts the rates to correct for differences in patient severity of illness between hospitals, the adjustment is not perfect.

How is UMHS Performing?

Heart failure patients who receive treatment at the University of Michigan Health System have a survival rate that is comparable to the national average. We are striving to improve our rate, even though we treat patients who are more severely ill than the comparison group in the national average.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

Heart Failure Re-Hospitalization

Details

Why is This Measure Important?

This measure is defined as the percentage of patients who were discharged from our hospital following treatment of heart failure and were then re-hospitalized within 30 days. This measure evaluates several aspects of care: the quality of care during the first hospitalization and the effectiveness of our efforts to educate patients about managing their disease and to coordinate care with the patients' outpatient physicians. Our goal is to address the patient's needs while they are in the hospital so that they do not experience problems when they return home.

It is important to keep in mind that our health system treats some of the most severely ill heart failure patients, which makes our re-hospitalization rates difficult to compare to those of other hospitals which treat heart failure patients who are not as ill. Although Medicare adjusts the rates to correct for differences in patient severity of illness between hospitals, the adjustment is not perfect.

How is UMHS Performing?

Re-hospitalization rates for heart failure patients at the University of Michigan Health System are mostly the same as the national average. Reaching this goal can be difficult when treating severely ill patients, however, we are working to be even better by improving patient education and coordinating follow-up care with the patient's outpatient physicians.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

In this section, we evaluate the care that heart failure patients receive during routine visits to their physicians. Unfortunately, we cannot compare our performance to that of other health systems because the data for other health systems are not available. Instead, we monitor our progress toward goals that we have established to ensure that we are providing the best care. We have almost reached our goals for these measures but will continue to assess our performance and our goals to ensure that we provide excellent care.

Testing Heart Pumping Strength
Higher Value = Better Performance

Details

Why is This Measure Important?

This measure is also called "ejection fraction assessment." It is used to report the percentage of heart failure patients who receive a test that evaluates how well their heart is pumping. The test is also used to classify heart failure severity so that patients can receive the most effective treatment for their condition. A higher percentage means better performance.

How is UMHS Performing?

At the University of Michigan Health System, the percentage of heart failure patients who received a test of their heart pumping strength has been consistently above 95%. There is no benchmark comparison. Instead we have established a goal of 95%, which we have surpassed.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: Institutional goal set by UMHS

Blood Pressure Control
Higher Value = Better Performance

Details

Why is This Measure Important?

When a person's blood pressure is high, the heart has to work harder to pump blood to the rest of the body. It is important for patients with heart failure to control blood pressure so that the heart can pump effectively without extra stress. This is a measure of the percentage of patients who have maintained their blood pressure below 140/90 mm Hg. A higher percentage means better performance.

How is UMHS Performing?

At the University of Michigan Health System, close to 80% of heart failure patients have maintained their blood pressure below 140/90 mm Hg. Our most recent result was 80%. There is no benchmark comparison. Instead we have established a goal of 80%. So, our performance is at the goal. The goal was set at 80% and not higher because the target blood pressure for individual patients will differ and will depend on the patient's clinical condition and compliance with treatment (i.e., taking prescribed blood pressure medication).

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: Institutional goal set by UMHS

Medication Use Ace Inhibitor and ARB
Higher Value = Better Performance

Details

Why is This Measure Important?

Patients with heart failure typically suffer from decreased function of the left side of the heart, which pumps blood to the rest of the body. Patients with heart failure are prescribed medications to make it easier for the heart to pump blood. Angiotensin-converting enzyme (ACE) inhibitors widen blood vessels, easing blood flow and decreasing the workload on the heart. These drugs help heart failure patients live longer. Angiotensin II receptor blockers (ARBs) serve as an alternative for people who cannot tolerate ACE inhibitors. This is a measure of the percentage of heart failure patients who receive a prescription for an ACE inhibitor or ARB. A higher percentage means better performance.

How is UMHS Performing?

At the University of Michigan Health System, the percentage of heart failure patients who received a prescription for an ACE inhibitor or ARB medication has been above 90%. There is no benchmark comparison. Instead we have established a goal of 95%. So, our performance is slightly below the goal. To improve our results, we are distributing reports to physicians that identify patients who should be considered for an ACE inhibitor or ARB at the time of their visit.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: Institutional goal set by UMHS

Medication Use - Beta Blocker
Higher Value = Better Performance

Details

Why is This Measure Important?

Beta blockers are medications that are used to help manage heart failure symptoms and improve heart function by slowing the heart rate and reducing blood pressure. This is a measure of the percentage of heart failure patients who are prescribed a beta blocker medication. A higher percentage means better performance.

How is UMHS Performing?

At the University of Michigan Health System, the percentage of heart failure patients who received a beta blocker has been above 90%. There is no benchmark comparison. Instead we have established a goal of 91%. So, our performance is slightly below the goal. To improve our results, we are distributing reports to physicians that identify patients who should be considered for a beta blocker at the time of their visit.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: Institutional goal set by UMHS.