Community Care of North Carolina

To Assure, enhance, and protect the health of our citizens through education and prevention.

Carolina Community Health Partnership

Congestive Heart Failure Quality Improvement Initiative
(CHF)

Providers participating in the Community Care of North Carolina Program agree to implement the Congestive Heart Failure Disease according to guidelines develop by the Heart Failure Society of America, American College of Cardiology (ACC) & the American Heart Association (AHA). The CCNC stages of Heart failure with recommended therapy guide summarizes initiative expectations (CCNC Heart Failure Guidelines)

Please visit CCNC website for initiative details, process measure and outcome measures.

The Carolina Community Health Partnership Network provides case management services to assist physician in implementation in heart failure disease management.

Table 1. Stages of HF

Stage	Description	Examples
A	Patients at high risk of developing HF because of the presence of conditions that are strongly associated with the development of HF. Such patients have no identified structural or functional abnormalities of the pericardium, myocardium, or cardiac valves and have never shown signs or symptoms of HF.	Systemic hypertension; coronary artery disease; diabetes mellitus; history of cardiotoxic drug therapy or alcohol abuse; personal history of rheumatic fever; family history of cardiomyopathy.
B	Patients who have developed structural heart disease that is strongly associated with the development of HF but who have never shown signs or symptoms of HF.	Left ventricular hypertrophy or fibrosis; left ventricular dilatation or hypocontractility; asymptomatic valvular heart disease; previous myocardial infarction.
C	Patients who have current or prior symptoms of HF associated with underlying structural heart disease.	Dyspnea or fatigue due to left ventricular systolic dysfunction; asymptomatic patients who are undergoing treatment for prior symptoms of HF.
D	Patients with advanced structural heart disease and marked symptoms of HF at rest despite maximal medical therapy and who require specialized interventions.	Patients who are frequently hospitalized for HF or cannot be safely discharged from the hospital; patients in the hospital awaiting heart transplantation; patients at home receiving continuous intravenous support for symptom relief or being supported with a mechanical circulatory assist device; patients in a hospice setting for the management of HF.
HF indicates heart failure.