Search engine scans cardiac catheterization and echocardiogram reports, emergency department, history and physical, operate, progress and radiology notes to include them in the HF Crawl List. Included patients with the following phrases:  fluid/volume overload  acute/decompensated chronic heart failure/CHF/HF  CHF/HF/HFrEF exacerbation  exacerbation heart failure volume overload HF exacerbation acute HF HF Crawl List Excluded patients with the following phrases:  grade 1  no vascular congestion seen/identified  cardiothoracic surgery post-operative progress note  not/no/suspect/possible/questionable/potential exacerbation Managing Heart Failure Every Day! • Weigh yourself first thing every morning after you urinate. • Take your medicines as directed. • Check for swelling or shortness of breath. • No more than 2000 mg of sodium and 6 to 8 cups of liquid per day. Warning! Call the cardiology office if: • Weight is up 3 pounds in a day or 5 pounds in a week. • Increased shortness of breath or cough. • Swelling or bloating. • Mild chest pains. • Trouble sleeping. STOP! Go to the ER or call 911 if you: • Are struggling to breathe. • Have new or severe chest pains. • Have confusion, dizziness, or fainting. Cardiology Office: Phone #: Heart Failure Interventions to Decrease 30-day Readmission 1 Recognition of HF Admission • Patient Identification • Cardiology Consult on High Risk Patients • Inpatient Care Coordination 2 Redesign Transition of Care • HF toolkit with Resources/Tools/Education • 3-7 Day Follow-up • Home Health Consultation 3 • Daily HF Huddle • Consistent HF orders • Transparency of HF admission • GDMT/Documentation • Outpatient Heart Failure Navigator • Pharmacy Input-Medications to Bedside • Self-referral to HF Clinic Enhance Follow-up Care • Medication Reconciliation • Consultations (Community Support, Cardiac Rehab, Nutrition, Advanced HF) • • • • GDMT titration Lab/Study Follow-up Communication of Plan HF education/Self-care