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Heart Failure Audit (HFA) Context Page

The Heart Failure Audit was established in 2007 to monitor the care and treatment of patients in England and Wales with acute heart failure. The audit reports on all patients discharged from hospital with a primary diagnosis of heart failure, publishing analysis on patient outcomes and clinical practice. Audit findings can be used to measure the implementation of contemporary guidelines for the clinical management of heart failure from the National Institute for Health and Clinical Excellence (NICE) and the European Society of Cardiology Heart Failure Association (ESC HFA). The audit is delivered by the National Institute of Cardiovascular Outcomes Research (NICOR) hosted by Barts Health NHS Trust.

To view the full audit data set visit the NICOR Heart Failure Audit website

Metrics:

Case ascertainment

  • Rationale: This metric shows the proportion of eligible cases that were submitted to the audit.
  • Guideline/mapping: There is no national guideline related to case ascertainment however NHS providers are required to participate in national clinical audit as part of their standard contract.
  • Graph/relative performance: Compare to the national aggregate (the average). Values can be greater than 100% due to coding discrepancies.
  • Quality improvement prompt question: Consider the other metrics in context of case ascertainment; particularly where ascertainment is low. If case ascertainment is low, this should be followed-up with the relevant audit lead to explore poor engagement.

Crude proportion of inpatients admitted with Heart Failure (HF) who receive input from the specialist team

  • Rationale: A dedicated specialist heart failure team with early involvement is important for cost‑effective care. It can also positively contribute to rapid diagnosis, reduced readmissions and better quality of life. Ongoing input of the dedicated specialist heart failure team will also help to ensure appropriate care and make subsequent readmission less likely.
  • Guideline/mapping: This metric maps to Quality standard [QS103] Quality Statement 3 “Adults admitted to hospital with acute heart failure have input within 24 hours of admission from a dedicated specialist heart failure team” with a standard of 100% in keeping with this QS.
  • Graph/relative performance: Compare to the national aggregate (the average) and national standard.
  • Quality improvement prompt question: When performance is lower than the national standard or national average this should prompt questions about how admissions with heart failure are identified and referred for specialist input and the capacity of the team to attend to patients.

Crude proportion of inpatients admitted with HF who receive cardiology follow up

Crude proportion of patients with HF with reduced fraction who are discharged from hospital on: an ACEI/ARB

Crude proportion of patients with HF with reduced fraction who are discharged from hospital on: Beta-blocker

Crude proportion of patients with HF with reduced fraction who are discharged from hospital on: Mineralocorticoid receptor antagonist (MRA)

 

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