Using a Heart Failure Acuity Algorithm for Emergency Admission Decision-Making
presented by: Robert Touchan, MD; Frank Smart, MD; Tony Joseph, MD
Presented August 26, 2009
| Heart failure is chronic and progressive. Nearly 100% of all heart failure patients decompensate at some point. It is common for individuals with decompensated heart failure to present to the Emergency Department (ED) for evaluation and treatment. A systematic algorithm based upon objective clinical variables can be used as a decision-making framework for this population of patients. Objective clinical variables (OCVs) can include historic data and physical findings as well as test results. Obtaining and organizing the OCVs in the ED prior to the admission decision permits the ED to become the site of decision-making that is often otherwise relegated to inpatient services. Once the ED becomes the site of decision-making the opportunity exists for the ED to become the site of service as well. Understanding the site of service decisions and how to move them from the inpatient unit to the emergency department can directly lead to length of stay and readmission rate reduction. Using an acuity adjusted algorithm for admission decisions is likely to lead to improved assessment of emergently decompensated patients with heart failure, earlier treatment, more effective admission decision-making, and result in decreased length of stay and readmission rates. |
About the presenters: |
 | Robert Touchan, MD is the Medical Director of the Kentucky Heart Institute, the 2006 recipient of the AHA’s Legacy of Life Award, and serves as the Education Committee Chair for the Healthcare Accreditation Colloquium. |
 | Frank Smart, MD is the Department Chair of Cardiovascular Medicine at Atlantic Health in New Jersey, well known in the heart failure community for his work in heart transplant services, and the Board Chair for the Healthcare Accreditation Colloquium. |
Tony Joseph, MD is well known for his work in cultural change and process improvement within healthcare. He is the current president of the Healthcare Accreditation Colloquium. |