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Differences in Organizational Structure to Support Patients with CHF and COPD

Rinne S, Liu C, Wong ES, Hebert PL, Au DH. Differences in Organizational Structure to Support Patients with CHF and COPD. Poster session presented at: AcademyHealth Annual Research Meeting; 2014 Jun 10; San Diego, CA.

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Abstract:

Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) First and second leading cause of hospital discharge within VA Strong organizational emphasis on CHF associated with adherence to NQF and other quality measures Despite being common, quality of COPD care has not been emphasized No performance measures within VA Current research suggests gaps in care National cross-sectional study of all VA Medical Centers with acute inpatient units Survey sent to Chiefs of Medicine and Cardiology/Pulmonary, respectively Queried about organizational support for the management of patients admitted for COPD or CHF Assessed feedback and measurement of quality and performance measures Quality based on NQF, NCQA and AHRQ Clearinghouse CHF survey produced by CHF QUERI administered in 2008 144 facilities COPD survey paralleled CHF survey administered in 2011 128 facilities 120 facilities that received both COPD and CHF surveys Analysis: where appropriate, parametric, non-parametric tested used. Response rate 100% CHF, 98% COPD Chiefs of Medicine, Cardiology/Pulmonary report marked differential programmatic support for patients hospitalized with CHF and COPD Limited organizational emphasis to support care for patients with COPD Generic performance measures (e.g. influenza vaccination) assessed by reporting agencies reflect strong organizational emphasis Programs developed by specialty services were similar between CHF and COPD





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