A computerized method of identifying potentially preventable heart failure admissions.

Area of Science:

• Cardiology
• Healthcare Management
• Nursing

Background:

• Heart failure (HF) presents a significant public health challenge due to its high prevalence and societal costs.
• Effective management of HF hinges on successful patient self-care.
• Current methods for identifying HF admissions linked to self-care deficits are insufficient.

Purpose of the Study:

• To develop a reliable method for identifying heart failure admissions caused by ineffective self-care using existing medical record codes.
• To create a validated list of diagnoses indicative of self-care related HF complications.
• To facilitate early intervention by enabling nurses to identify at-risk patients.

Main Methods:

• Expert panels iteratively developed and validated a list of diagnoses associated with self-care modifiable HF sequelae via mailed surveys.
• International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes were investigated for their utility in identifying these diagnoses.
• Chart review was conducted at a single hospital to assess the frequency of these modifiable sequelae and their coding accuracy.

Main Results:

• A consensus was reached among expert panels, resulting in a list of sixteen diagnoses representing HF sequelae influenced by self-care.
• Chart review indicated that these modifiable sequelae were frequently present in patients but often not accurately coded in medical records.
• The study highlights a gap in the current coding practices for HF complications related to self-care.

Conclusions:

• A validated list of self-care-modifiable HF diagnoses has been established.
• Current medical record coding practices frequently underrepresent HF admissions attributable to ineffective self-care.
• A computerized system for identifying these self-care deficits could significantly enhance nurses' ability to target patient education and support.