CHP Heart Failure GAP (Guidelines Applied in Practice)

描述(由申请人提供)：天主教保健伙伴(CHP)之前向AHRQ提出的题为“心力衰竭(HF)GAP(实践中应用的指南)”的提案迄今非常成功。到目前为止，第一阶段包括规划和积极实施对慢性阻塞性肺疾病患者的全面质量改进工作 根据医学研究所最近提出的国家优先事项，国际心脏协会将继续开展这项工作。该项目目前的主要目标包括：(1)调整全国公布的心力衰竭指南和相关质量措施，用于天主教保健伙伴系统，该系统由5个州的31家医院组成(2003年期间出院的心力衰竭患者超过8.000人)；(2)开发一个知识传授框架，以实施指导方针并推动显著改善慢性心力衰竭患者的护理质量；(3)开发和实施支持第一个和第二个目标的计算机化医嘱录入系统的原型，特别是在管理慢性病状态的背景下 (4)展示卫生防护中心有能力在各种不同的卫生保健组织、提供者团体、专业医学会和卫生保健信息技术公司及其利益攸关方之间建立和维持有效的、基础广泛的伙伴关系。CHP HF GAP计划的第二阶段目标包括更多地关注慢性HF患者的门诊护理协调、支持基础设施和临床质量改进过程。开发、描述和评估的其他领域包括将慢性心力衰竭护理的质量衡量扩大到门诊；确定新出现的慢性心力衰竭疾病管理计划的影响和接受度；外部和组织激励付款对展示可衡量的质量改进的影响；培养临床心脏病学的领导力，以促进 这些活动包括：改善慢性心力衰竭的护理；克服当前卫生系统面临的挑战，特别是那些具有潜在负面财务影响的挑战；实施提高质量的干预措施，加强自我管理；提高生活质量，包括促进为那些处于或接近生命末期的晚期慢性心力衰竭患者提供姑息治疗服务。

DESCRIPTION (PROVIDED BY APPLICANT): Catholic Healthcare Partners' (CHP) previous proposal to AHRQ entitled "Heart Failure (HF) GAP (Guidelines Applied in Practice)" has been highly successful to date. Phase 1 has thus far consisted of both planning and active implementation of a comprehensive quality improvement effort for patients with chronic HF in accordance with national priorities recently set forth by the Institute of Medicine. Current major aims of this project include: (1) Adaptation of nationally published HF guidelines and associated quality measures for the Catholic Healthcare Partners system, consisting of 31 hospitals located in 5 states (which discharged over 8.000 patients with HF during calendar year 2003); (2) Development of a knowledge transfer framework to implement guidelines and motivate significant quality improvements for care of patients with chronic HF; (3) Development and implementation of a prototype for computerized physician order entry ("CPOE") systems that support the first and second aims, especially in the context of managing a chronic disease state such as HF, and (4) Demonstration of CHP's ability to establish and sustain effective, broad-based partnerships among a variety of diverse health care organizations, provider groups, professional medical societies and health care information technology corporations and their stakeholders. Phase 2 goals for the CHP HF GAP initiative include a larger focus on outpatient care coordination, support infrastructure and clinical quality improvement processes for patients with chronic HF. Additional areas of development, description and evaluation include expanding the use of quality measurement for chronic HF care to outpatient settings; defining the impact and acceptance of emerging chronic HF disease management programs; the influence of external and organizational incentive payments for demonstrating measurable quality improvement; the fostering of clinical cardiology leadership to promote quality improvements for chronic HF care; overcoming current health system challenges, especially those with potentially negative financial implications, for implementing quality improvement interventions that enhance self-management; and demonstrating improved quality of life, including the promotion of palliative care services for those patients with advanced chronic HF who are at or near the end of life.