Background: Assessing the quality of care is the first step for improve the management of patients with acute heart failure (AHF). The European Society of Cardiology (ESC) recently defined a set of quality indicators (QI) of care for AHF.
Aim: To evaluate the quality of care of patients admitted to the Cardiology ward of our first level hospital for an AHF using the ESC QI.
Methods: QiC project is a prospective quality improvement study in real-world practice on all patients admitted in our ward for an AHF from 1.5.2023 to 30.4.25 with six-monthly audit activities. Case record forms were filled in by doctors during admission and were attached to the patient’s discharge letter. The ESC QI include 12 main and 4 secondary QI on structural framework, patient assessment, initial treatment, and assessment of patient health-related quality of life. For each QI was evaluated the percentage of QI assessable and attained.
Results: A total of 39 patients were admitted for AHF in our Cardiology Department in the first 3 months. One patient denied consent, one died during hospitalization, 5 patients had to be transferred to another hospital, and 7 did not have their record form filled in. The median age of the 25 patients discharged alive was 76 (IQR 64-83) years, 17 (68.0%) were males, 3 (12.0%) had a preserved, 1 (4.0%) mildly reduced, and 21 (84.0%) reduced ejection fraction. The percentages of non-assessment, non-attainment and attainment for each QI are reported in the Figure: the degree of non-assessment of the 16 QI ranged from 0 to 16% and the degree of QI attainment from 12 to 100%.
Conclusions: The quality of care for acute heart failure can be measured in the majority of patients admitted to our Cardiology Department using the ESC quality indicators. Although the majority of quality indicators are met in our patients, a large room for improvement is present in the domain of the patient assessment (mainly in completeness of blood tests and cardiac rehabilitation programme), of the initial treatment (SGLT2 inhibitor prescription), and of the assessment of patient health-related quality of life.
