Quality standard
Quality statement 3: Organisation of care – early specialist input
Quality statement 3: Organisation of care – early specialist input
Quality statement
Adults admitted to hospital with acute heart failure have input within 24 hours of admission from a dedicated specialist heart failure 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.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that adults admitted to hospital with acute heart failure have input within 24 hours of admission from a dedicated specialist heart failure team.
Data source: Local data collection.
Process
a) Proportion of adults admitted to hospital with acute heart failure who have input within 24 hours of admission from a dedicated specialist heart failure team.
Numerator – the number in the denominator who receive input within 24 hours of admission from a dedicated specialist heart failure team.
Denominator – the number of adults admitted to hospital with acute heart failure.
Data source: Local data collection. National data are collected in the National Institute for Cardiovascular Outcomes Research heart failure audit 2012/13.
Outcome
a) Mortality rates.
Data source: Local data collection. National data are collected in the National Institute for Cardiovascular Outcomes Research heart failure audit 2012/13.
b) Readmission rates.
Data source: Local data collection. National data are collected in the National Institute for Cardiovascular Outcomes Research heart failure audit 2012/13.
What the quality statement means for different audiences
Service providers (cardiac service providers) ensure that adults admitted to hospital with acute heart failure have input within 24 hours of admission from a dedicated specialist heart failure team.
Healthcare professionals ensure that adults admitted to hospital with acute heart failure have input within 24 hours of admission from a dedicated specialist heart failure team.
Commissioners ensure that adults admitted to hospital with acute heart failure have input within 24 hours of admission from a dedicated specialist heart failure team.
Adults admitted to hospital with acute heart failure have contact with a team within 24 hours of admission that specialises in treating heart failure and that is involved in their early care.
Source guidance
Acute heart failure: diagnosis and management. NICE guideline CG187, recommendation 1.1.2 (key priority for implementation)
Definitions of terms used in this quality statement
Input within 24 hours of hospital admission
Review and address the needs of acute heart failure patients within 24 hours of hospital admission. [Expert consensus]
Dedicated specialist heart failure team
This specialist inpatient team includes doctors, nurses (including heart failure specialist nurses), pharmacists, physiotherapists and psychologists, and has access to a palliative care specialist and other expertise as required. The team is led by a consultant specialist with a sub‑speciality interest in heart failure. This team is based on a cardiology ward but also provides outreach services to heart failure patients on all other wards within the hospital. It is also part of a broader multidisciplinary specialist team working across primary and secondary care, as outlined by NICE guidance. [Adapted from NICE's guideline on chronic heart failure and expert consensus]