Heart Failure Management FINAL2 Audit Form 2008

A0d823

Informations

• Publié par: Indo
• Nombre de lectures: 17
• Langue: English

Extrait

B l u e C r o s s a n d B l u e S h i e l d o f M i n n e s o t a R e c o g n i z i n g E x c e l l e n c e 2008 Heart Failure Management Audit F o rm P ayfor performance progr am Last Updated:10/7/08 Blue Cross and BlueShield of Minnesota is alicensee of the Blue Cross and Blue Shield Association

2008 Recognizing Excellence (RE) Medical Record Audit Form Numerator Tally Heart Failure Management Meets RE criteria?1Yes1No Date of Review: ____/____/___Reviewer: ____________________ Clinic Sample ID#: _________Clinic System:____ ____________ Specialty:CardiologyClinic site: __________________BCBS Member ?1Yes1No Clinician ID (optional): _____________ Instructions: Review only the charts that meet the verified inclusion criteria referenced in the criteria summary table (patient’s age 18 and older, diagnosis of heart failure prior to Dec. 31, 2008, dates of service going back 1 year from Dec. 31, 2008). Answereach question with either yes or no.Missing information is considered a NO.Retain this audit tool with your Recognizing Excellence records for reference.

Verify Inclusion Criteria: 1. Isthe patient age 18 or older as of Dec. 31, 2008? (Date of birth on or before Dec. 31, 1990) 1Yes 1No If the answer is yes, proceed with next question. If no, do not include this record in the denominator. Pull a new medical record from eligible population identified. 2. Doesthe patient have a diagnosis of heart failure on or before Dec. 31, 2008? 1Yes 1No If the answer is yes, proceed with next question. If no, do not include this record in the denominator. Pull a new medical record from eligible population identified. 3. Hasthe patient ever have a diagnosis of left ventricular systolic dysfunction (LVSD)?LV test results with EF < 40 (echocardiogram, radionuclide ventriculogram, left ventriculogram, MRI, heart catheterization, noninvasive bioimpedance hemodynamics). 1Yes 1 No If the answer is yes, proceed with next question. If no, do not include this record in the denominator. Pull a new medical record from eligible population identified. 4. Isthe patient enrolled in hospice services? 1Yes 1 No If the answer isno, proceed with next question. Ifyes, do not include this record in the denominator. Pull a new medical record from eligible population identified.

Assess care of patients’ age 18 and older diagnosed with Heart Failure based on the following measures: 1. Inthe last 12 months, was the patient prescribed or on an ACE inhibitor or Angiotensin II Receptor Antagonist (ARB)?(see medication list) 1Yes 1 Allergyor relative clinical contraindications, e.g. hyperkalemia (>5.5 meq/mL), severe renal artery stenosis, cough with an ACE  Inhibitoror angioedema. 1No 2. Inthe last 12 months, was the patient prescribed or on a Betablocker medication?(see medication list) 1Yes 1Allergy or relative clinical contraindications, e.g. severe LV dysfunction, SBP <100, HR < 60 bpm, reactive airway disease, heart st  block> 1degree) to Betablockers. 1No 3. Isthe patient a tobacco user? 1Yes 1No Recognizing Excellence (RE) Numerator Checklist: Include this record in numerator of Heart Failure management and/or Recognizing Excellence performance measure? Numerator: If question 1 and 2 areyesand 3 isno, include in numerator forDocumentation ofHeart Failure Management. contraindication is consideredyes. (Check yes box in Heart Failure management and/or Recognizing Excellence performance measure Numerator Tally – top of page on the audit form) Denominator: If question 1 or 2 isno, or question 3 isyes, this audit record cannot be included in the numerator. This record is included in the denominator. Check no box in Reconizin ExcellenceNumerator Tall fronta eof audit form

Heart Failure Management:Medication Reference List BetaBlockers: Generic Name Available Agents Acebutolol Sectral Atenolol Tenormin Betaxolol Kerlone Bisoprolol Zebeta Carvedilol Coreg,Coreg CR Esmolol Brevibloc(IV only) Labetalol Trandate Metoprolol tartrate Lopressor Metoprolol succinate LA Toprol XL Nadolol Corgard Nebivolol Bystolic Penbutalol Levatol Pindolol Visken Propranolol Inderal Propranolol LA Inderal LA Propranolol LA InnoPran XL Sotalol Betapace Sotalol BetapaceAF Timolol Blocadren Combination Products: Generic Name Available Agents Atenolol/chlorthalidone Tenoretic Bisoprolol/HCTZ Ziac Metoprolol/HCTZ LopressorHCT Nadolol/bendroflumethiazide Corzide Propranolol/HCTZ Inderide Timolol/HCTZ Timolide ACE Inhibitors: Generic NameAvailable Agents Lisinopril Prinivil Prinzide Zestril Zestoretic Quinapril Accupril Accuretic Fosinopril Monopril Captopril Capoten Capozide Enalapril Vasotec Vaseretic Benazepril Lotensin Lotensin HCT Moexipril Univasc Uniretic Trandolapril Mavik Ramipril Altace Perindopril Aceon

Available Generically YES YES YES YES YES( COREG ONLY) YES

YES YES YES NO NO YES YES YES NO YES YES YES Available Generically YES YES YES YES YES YES

Available Generically YES

YES

YES YES

YES

YES

YES

YES YES NO

Angiotensin Receptor Blockers and Angiotensin Receptor Blocker/Diuretic Combinations: Candesartan Eprosartan IrbesartanLosartanOlmesartan Telmisartan Valsartan (Atacand) (Teveten)(Avapro) (Cozaar)(Benicar) (Micardis) (Diovan) A nH TT vn HT Avli Hz rB nir HT Mir iH T Diovan HCT