North Texas GME Research Forum 2024

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Division

North Texas

Hospital

Medical City Weatherford

Specialty

Internal Medicine

Document Type

Poster

Publication Date

2024

Keywords

quality improvement

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences | Quality Improvement

Abstract

Each year, 700,000 patients are hospitalized with acute decompensated congestive heart failure. In order to effectively treat these patients, they require delicate management of volume status. Measuring volume status incorporates the following components: recording strict inputs and outputs of urine/fluids, recording daily standing weights and fluid restriction. This project focused on recording daily weights as a measure of accurate volume status and how that affected length of hospital stay. Data will be gathered by patient chart review including patient's admitted from Jan 2023 -Jan 2024 at Medical City Weatherford admitted with a primary/admitting diagnosis of congestive heart failure. Using PDSA framework, we will investigate if measurements of daily weights were consistently recorded and if they impacted a patient's length of stay. During course of investigated, it was discovered a potential gap specifically utilization of the order set in measuring daily weights, initially an order needs to be placed for daily weights; second, a daily weight has to be recorded by a patient care tech/nurse. In order to improve a 10% usage of daily weights in 1-month education was provided to residents regarding CHF order set usage upon admission, introduction of printed and digital management index cards, and implementation of "favorite order sets" in Meditech. In conclusion, we noted a shorter length of stay with patients who had consistent daily weights orders in place on admission.

Original Publisher

HCA Healthcare Graduate Medical Education

Early Implementation of CHF Orders and Physician Education​

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