Please note: This toolkit is an archived resource and is no longer being updated.
The CHF QUERI Center has developed a comprehensive Heart Failure (HF) Toolkit for Providers through collaboration with the members of its Heart Failure Provider (HF) Network as well as non-VA organizations. These tools are organized as tools from VA Sources, Non-VA Sources:Other; and Non-VA Sources: GWTG-AHA (Get With The Guides - American Heart Association).
This toolkit focuses on several key areas in the management of heart failure. We encourage all providers to review the toolkit to determine where these tools will be helpful in their practice and download relevant tools for their use.
All PDF files below are available upon request by sending an email to the VA HSR&D web team at HSRDWeb.Boston@va.gov.
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HF CLINICAL PATHWAYS
VA Sources
- CHF Pathway: Grand Junction VA (PDF)
- Clinical Pathways (Inpatient) Chart: Durham VA (PDF)
Non-VA Source: GWTG-AHA
- HF Pathway: Memorial Health System (PDF)
- Clinical Pathway: Memorial Health System (PDF)
HF SCREENING FORMS AND CHART REMINDERS
Non-VA Sources
- CHF Chart Reminder: St. Anthony Hospitals
- Congestive Heart Failure Checklist: Marion General Hospital
- Heart Failure Progress Note: Denton Regional Medical Center
HF ADMISSION ORDER SETS
VA Source
- Disease Management Consult and Inpatient Orders: Durham VA
Non-VA Source: GWTG-AHA
- HF Admission Orders: Marion General Hospital (PDF)
- HF Order Sets: Hazleton General Hospital (PDF)
- HF Order Sets: Memorial Health Systems (PDF)
- HF Order Sets: Quincy Medical Center (PDF)
HF DISCHARGE PROCESS, ORDERS, AND INSTRUCTIONS
VA Source
- Discharge Planning Templates: Durham VA (PDF)
- Discharge Summary Checklist: CHF QUERI (PDF)
- Flow Map_Discharge Process F-4E: Marion, IN VA (PDF)
- Flow Map_Revised Discharge Process: Marion, IN VA (PDF)
- Nursing Discharge Instructions: Grand Junction VA (PDF)
- Diuretic Regimen for 4B: Providence VA
Non-VA Source: GWTG-AHA
- Congestive Heart Failure Discharge Orders: Marion General Hospital (PDF)
- Discharge Instruction Form: Hazleton General Hospital (PDF)
- Discharge Instruction Sheet: Cleveland Clinic (PDF)
- Discharge Instruction Sheet: Coral Gables Hospital (PDF)
- HF Discharge Instructions (Device Insertion): Memorial Health Systems (PDF)
- HF Discharge Instructions: Memorial Health Systems (PDF)
- Universal Instructions for Your Care At Home: Vassar Brothers Medical Center (PDF)
Non-VA Sources: Other
- Discharge Instruction Sheet: Cleveland Regional Medical Center (PDF)
HF MEDICATION
VA Source
- Medication Reconciliation: Cleveland VA (PDF)
- Flexible Diuretic Protocol: Cleveland VA (PDF)
Non-VA Source: Other
- Medication Reconciliation: Hahnemann University Hospital
HF BEST PRACTICES
VA Source
Non-VA Source: GWTG-AHA
- 100% Compliance with HF Discharge: The Economic Impact (PDF)
- Admission Time-Out Tool Core Measure (PDF)
- Analysis of Cost Savings (PDF)
- Discharge Time-Out Tool Core Measure (PDF)
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- HF Physician Outlier Letter: St. Anthony Hospitals (PDF)
- Implementation Tips (PDF)
- Implementing GWTG: Barriers and Facilitators (PDF)
- Implementing Mandatory Use of Order Sets (PDF)
- MD and Staff Compliance (PDF)
- Protocol for Identifying HF Patients at Admission and Discharge (PDF)
Non-VA Sources: Other
- Fact Sheet for HF: CDC
- Summary and Strategies For Getting Started - How To Guide: Institute For Healthcare Improvement (PDF)
- Mary Naylor Transitional Care Model's Implementation Protocol
- Canadian Heart Failure Network's "Making a clinic work"
- Project Red
HF-RELATED PROVIDER EDUCATION TOOLS
VA Sources
- CHF Primary Care Nursing Competency: Martinez VA (PDF)
- CHF RN Competency: Martinez VA (PDF)
- HF Knowledge Questions: Nashville VA (PDF)
- Nursing Satisfaction With Rounding Questionnaire: Marion, IN VA (PDF)
- Performance Measure: Marion, IN VA (PDF)
- Physician Satisfaction With Rounding Questionnaire: Marion, IN VA (PDF)
Non-VA Sources: Other
HF-RELATED PATIENT EDUCATION MATERIALS
VA Sources
Non-VA Sources
- American Heart Association
- Ask Me 3: Institute for Healthcare Improvement
- Atlanta HF Knowledge Test
- CHF Patient Education Documentation: Cleveland Regional Medical Center
- Health Informatics International
- Heart Failure Society of America
- HF Self Management Goals: Institute for Healthcare Improvement (PDF)
- Krames On Demand
- Patient Family Teaching Record: Cleveland Clinic Florida
- Patient Knowledge of Self-care Activities in Congestive Heart Failure (PaKSAC) Survey
- Canadian Heart Failure Network - Patient Education
- The Iowa Health System Health Literacy Collaborative: Teach-back: A Health Literacy Tool to Ensure Patient Understanding
- American Association of Heart Failure Nurses (AAHFN) - HF Self-Care
Non-VA Sources: Other
- Ethnic Food Nutrient Table
HF-RELATED CAREGIVER MATERIALS
VA Source
Non-VA Source
Non-VA Source: Other
- Ethnic Food Nutrient Table
HF-RELATED COMMUNICATION TIPS FOR PATIENTS
VA Source
- Communication Tips: Charleston VA (PDF)
HF-RELATED QUALITY OF LIFE MEASURES
Non-VA Sources
- Kansas City Cardiomyopathy Questionnaire: John Spertus
- Minnesota Living With Heart Failure Questionnaire: Thomas Rector
HF MORTALITY RISK MODELS
Non-VA Source: GWTG-AHA
- Predictions of In-Hospital Mortality Poster
Non-VA Sources: Other
LINKS TO TRACK HF OUTCOMES
VA Sources
- OQP: http://vaww.pdw.med.va.gov/FacilityReport/FRIndex.asp?qtr=20084&typ=12&FromEBB=1&PreRelease (Intranet only; copy and paste link into your browser.)
Non-VA Sources
- VA Hospital Compare
- Hospital Compare (includes VA and non VA hospitals)
HF-RELATED NON-VA ORGANIZATION WEBSITES
Non-VA Sources
HF-RELATED TOOLKIT
VA Source
- PACT Toolkit - This is available on the intranet only. Please copy and paste this URL into your browser: https://vaww.visn11.portal.va.gov/sites/VERC/va-case/info/PACTToolkit/SitePages/Home.aspx