Increase interdisciplinary communication Strategies: Improving data collection processes Increase interdisciplinary communication Involving community providers (HHA, SNF) Addressing social issues, offering resources and knowing what resources are available Improving transition of care through communication with PCP’s and physicians outside of the hospital system.

The Burden: PCI-associated Bleeding Impacts Health Care Facilities and Patient Health CMS CMS applying pressure to provide quality care AND control cost Readmission rates Volume of PCIs performed is steadily increasing. Significant cost burden Readmissions are costly to patients and society Severity of adverse events and long-term outcomes Any amount of bleeding as a result from PCI is associated with worsened ischemic outcomes, MI, stent thrombosis, and death. These challenges can be solved by implementing proven, evidence-based tools.

PCI Bleeding: A Growing National Challenge # of PCIs nationally in 2017: 763,000 # of PCIs at [facility] in 2017: [X] (place holder for facility to insert own name and #) PCI in-hospital risk standardized bleeding, Nationally: 2.81% PCI in-hospital risk standardized bleeding, [facility]: X.XX%

Reduce the Risk: PCI Bleed Quality Campaign Goal Motivating widespread adoption of evidence-based practices to improve quality of care Improve bleeding rates and decrease variances in data Decreasing Bleeding Rates

(Facility Name) Strategic Goal Empty Slide to drop in facility’s own strategic goals, highlighting which could be supported by participating in the Reduce the Risk: PCI Bleed Campaign.

Campaign Metrics Campaign Metrics No Additional Data Collection! # Program Metric Metric Description Data Source Performance Measures 1 CathPCI Registry Performance Measure #40. PCI in-hospital risk-standardized rate of bleeding events for all PCI patients Bleeding complications after PCI are associated with increased morbidity, mortality and costs. This measure is helpful in providing risk-adjusted feedback on bleeding complications, informing clinical decision-making, and directing the use of bleeding avoidance strategies to improve the safety of PCI procedures. CathPCI Registry 2 CathPCI Registry Quality Metric #25. Proportion of PCI procedures with transfusion of whole blood or red blood cells Numerator: Count of PCI procedures with a RBC/Whole blood transfusion procedure. Denominator: Count of PCI Procedures The purpose of this metric is to allow identification of potential overuse of transfusion after PCI procedures. In addition, it points out blood loss, which predicts poor outcomes. Outcomes Measures 3 Detail Line #1820: Procedures with an observed bleeding event Count of bleeding event post PCI procedure. CathPCI Registry  Process Measures 4 CathPCI Registry Detail Line #1596-1602: Anticoagulation utilization Detail Line #1596: All Anticoagulants Detail Line #1597: Fondaparinux Detail Line #1598: Low molecular weight heparin (any) Detail Line #1599: Unfractionated heparin (any) Detail Line #1600: Heparin-LMWH/Unfractionated(any) Detail Line #1601: Direct thrombin inhibitors Detail Line #1602: Bivalirudin 5 CathPCI Registry Detail Line #1656-1659:  Access site utilization.   Indicate the primary location of percutaneous entry. Code the site used to perform the majority of the procedure if more than one site was used. Detail Line #1656: Femoral Detail Line #1657: Brachial Detail Line #1658: Radial Detail Line #1659: Other 6 CathPCI Registry Detail Line #1661-1667: Method for closure for arterial access site. Indicate the arterial closure methods used in chronological order regardless of whether or not they provided hemostasis. The same closure method may be repeated Detail Line #1661: Manual compression Detail Line #1662: Mechanical compression Detail Line #1663: Suture Detail Line #1664: Staple Detail Line #1665: Sealant Detail Line #1666: Patch Detail Line #167: Other, unspecified device

QII Participant Change Package Participant access to suite of support materials QII Participant Change Package Assessment Toolkit Calls & Webinars Listserv Dashboard Includes benchmarking data, and is designed to identify opportunities for improvement Specific tools and strategies designed to address one general topic area for improvement Listen to community calls and on-demand webinars that review evidence based toolkits and lessons learned Collaborate and interact with others on a listserv who share best practices and lessons learned A customized data dashboard to tack your progress and benchmark against other facilities

Earn “High” weighted credit for this MACRA MIPS Improvement Activity! .

Customizable Closing Slide Where have we been? Where are we today? Where are we going?