• Institute for Clinical Systems Improvement (ICSI). Heart failure in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Aug. 119 p. [217 references]

Does not apply to this measure

This measure is used to assess the percentage of adult heart failure patients who have not used tobacco anytime during the previous year.

The priority aim addressed by this measure is to improve care of adult heart failure patients by assuring comprehensive patient education and follow-up care.

Heart failure; smoking status

Number of adult heart failure patients who had a clinic visit during the month in question (see the related "Denominator Inclusions/Exclusions" field in the Complete Summary)

Number of adult heart failure patients who have not used tobacco anytime during the previous year* at the time of the clinic visit

*A non-smoker is defined as someone who did not use tobacco anytime during the previous year.

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Monitoring health state(s)

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

Age greater than or equal to 18 years

Either male or female

Unspecified

Heart failure is a major health problem in the United States, and the incidence of the disease is projected to increase. It was the most frequent diagnosis of Medicare patients discharged from the hospital in 2001. There are an estimated 5 million individuals currently diagnosed with heart failure, 550,000 new cases diagnosed annually, and 1 million people hospitalized annually (including readmission rates of 30 to 60%).

• Institute for Clinical Systems Improvement (ICSI). Heart failure in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Aug. 119 p. [217 references]

Unspecified

There are over 260,000 annual deaths from heart failure. From 1979 to 2000 heart failure death rates have increased 148% and hospital discharges have increased 165%. The prognosis of patients with a new diagnosis of heart failure is poor. Senni et al. (1998) noted survival to be 86% at 3 months, 76% at one year, and only 35% at 5 years.

See the "Incidence/Prevalence" field.

Unspecified

Not within an IOM Care Need

Not within an IOM Domain

Users of care only

Adult heart failure patients who had a clinic visit during the month in question.

The measurement period is monthly. Monthly data will be submitted quarterly.

The minimum sample size is 20 patients per month.

Patients associated with provider

Inclusions
Number of adult heart failure* patients who had a clinic visit** during the month in question.

*International Classification of Diseases, Ninth Edition (ICD-9) codes: 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9. (Refer to the table, "Descriptions of ICD-9 Codes," in the original measure documentation for code descriptions.)

**The clinic visit is described as an office visit with a physician, nurse practitioner, or physician assistant. Education office visits may include a visit with a nurse.

Exclusions

• Patients who are less than 18 years of age
• Exclude visits for the purpose of testing or device checks only.

All cases in the denominator are not equally eligible to appear in the numerator

Clinical Condition
Encounter

Time window is a single point in time

Inclusions
Number of adult heart failure patients who have not used tobacco anytime during the previous year* at the time of the clinic visit

*A non-smoker is defined as someone who did not use tobacco anytime during the previous year.

Exclusions
Unspecified

Unspecified

Fixed time period

Administrative data
Medical record

Does not apply to this measure

Health Risk State or Behavior

Unspecified

Rate

A lower score is desirable

Unspecified

Internal time comparison

Unspecified

Percentage of adult heart failure patients who have not used tobacco anytime during the previous year (primary care and outpatient cardiology).

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne, and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: Stephen Kopecky, MD (Work Group Leader) (Mayo Clinic) (Cardiology); Rufino Festin, MD (Park Nicollet Health Services) (Cardiology); Peter Smars, MD (Mayo Clinic) (Emergency Medicine); Mohammad T. Fareed, MD (Avera Health) (Family practice); Ashok Ojha, MD (Hutchinson Medical Center) (Internal Medicine); Mary Jo Macklem, RN (Park Nicollet Health Services) (Nursing); Joshua E. Breeding, PharmD, BCPS (Fairview University Medical Center) (Pharmacy); Robert Straka, PharmD (University of Minnesota Physicians) (Pharmacy); Angela Turner, Pa-C (Park Nicollet Health Services) (Physician Assistant); Penny Fredrickson (Institute for Clinical Systems Improvement) (Measurement Advisor); Ann-Marie Evenson, BS, RHIT (Institute for Clinical Systems Improvement) (Facilitator)

Measure was not adapted from another source.

2006 Aug

2007 Aug

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Heart failure in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Aug. 116 p.

• Institute for Clinical Systems Improvement (ICSI). Heart failure in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Aug. 119 p. [217 references]

This NQMC summary was completed by ECRI on November 29, 2006. This NQMC summary was updated by ECRI Institute on December 16, 2007.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.