Aurora Health Care

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Aurora Health Care

• Aurora St. Lukes Medical Center
• Milwaukee, WI.
• Get With the Guidelines Presentation
• August 29, 2007
• Natalie Singer RN

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Background St. Lukes Medical CenterAurora
Health Care

• System
• 14 Hospitals in System
• 80 clinics
• 130 Pharmacies
• SLMC- Tertiary Access Center
• Licensed for 938 beds
• Submit data to Premier, CMS, GWTG-HF, Stroke
  CAD , STS and ACC-NCDR
• Many physicians are private practice
• Cardiology Resident program

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GWTG background for ASLMC

• Submitting to Get With the Guidelines HF since
  March, 2006 CAD since 2003
• CAD Summary Tool
• HF Average 70-80 patients per month over 1,000
  patients submitted to date

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Using the GWTG Reporting System

• Submit all patients through web-based tool
• Ongoing running of reports through web-based
  reporting system up to date reporting
• The Composite Performance Measure gives us an
  overall sense of performance have to be doing
  well in all measures to have good scores.
• HF Defect-Free Care Measure allows us to see that
  we are providing best care/interventions on all
  required measures for all eligible patients.
• The reports also help us drill down on individual
  measures, evaluate clinical practice patterns and
  track patient outcomes.
• Can benchmark to like facilities and National
  levels
• Allows for baseline data and measuring of process
  improvements

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Using the Reports from GWTG

• Reports reviewed with the Director and Cardiac
  Program Manager to evaluate our cardiac program
  which has led to the following
• Developed HF specific team within our facility to
  focus on the measures and work towards
  implementing best practice.
• Heart Failure Coordinators two RNs who see
  inpatients with diagnosis of HF to ensure that
  all of the measures have been met and documented
  prior to discharge.
• Identify barriers to measures we could improve on
  and help to strategize new approaches to care.

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Barriers

• Example of Issue
• Physicians not documenting EF for patients with
  LVSD lack of contraindications documented when
  not prescribing ACE or ARB medications.
• Action to Correct
• Development of Standardized Heart Failure order
  sets.
• Heart Failure Coordinators monitor usage of
  orders, check documentation and follow up with
  physicians and nursing.
• Physician report cards provided by QM to show
  areas of success and deficits.

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Outcome

• We saw an increase in our measure of LV
  documentation and better documentation of
  contraindications.
• This led to an overall increase in those measures
  and gave us better Composite Performance and
  Defect-free measures.
• Documentation and care has changed and has led to
  better HF pt management.

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Additional Reporting Options

• Benefits of participating in Get With the
  Guidelines
• Met our Initial Achievement Performance Award
• Met our Annual Performance Achievement Award
• Evidence per reporting that we are providing
  best practice and defect-free care to our
  heart failure patients.

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Final Thoughts
Through participating in Get with the Guidelines,
we have been able to identify areas of success,
needs for improvement and able to measure our
outcomes through the data reporting made
available to us. We can see, not only individual
measures, but track overall composite performance
and defect-free care over time to ensure we are
providing the best care and helping to save more
lives. There is a wide variety of resources
available through the website as well as patient
specific information when entering into the
web-based tool.
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Thank You!!