In 2002, the Joint Commission on Accreditation of
Healthcare Organizations identified heart failure care and
outcomes as one of the initial priority focus areas for
hospital core measure development. Four key measures
were identified: left ventricular function assessment,
adult smoking cessation advice/counseling, angiotensinconverting
enzyme inhibitor (ACEI) administration for
left ventricular systolic dysfunction, and discharge instructions.
The discharge instructions consisted of six
components, including a written list of medications, limiting
fluid and salt intake, weighing daily, exercise, reporting
worsening signs and symptoms, as well as making
a follow-up appointment with the patient’s physician.
All components were measured for patients with
a primary discharge diagnosis of heart failure (The Joint
Commission, 2002).