Heart failure (HF) is a serious condition and a major health problem in the United States with significant associated costs. Despite major advances in treatment, standardized performance measures, and evidence-based national guidelines, heart failure continues to be a substantial cause of mortality and morbidity. Since the early 1990s, improving patient safety and chronic disease outcomes has become a national priority. In an effort to improve the healthcare delivery process, a healthcare accreditation organization, The Joint Commission (TJC) developed evidence-based performance measures for HF and three other chronic diseases. Other organizations, such as the Institute of Medicine (IOM) and the Institute for Healthcare Improvement (IHI), have started campaigns with targeted interventions for improving the care of patients with HF. Healthcare organization compliance with performance measures is one of the requirements for obtaining and maintaining accreditation and certification status from TJC. While a group of hospitalist providers at local facility, accredited by TJC, recognized the effects of HF, they were not consistently complying with the HF performance measures. Additionally the group did not have a standardized protocol in place for the performance measures or for the discharge process for patients with HF. The capstone project was an evidence-based outcomes management plan directed at improving the care of patients with HF by changing clinical practices. The short term objectives of the project were to: (a) create a standardized HF discharge protocol based on the four HF performance measures (b) implement the protocol at the facility for patients with HF admitted to the hospitalist provider’s service and (c) evaluate the hosptialist provider’s compliance with the four HF performance measures both before and after implementation of the protocol. Long-term project objectives included laying a foundation for future development and use of standardized discharge protocols for all patients admitted to the facility.
