1. Physician Progress Record JACC Appropriateness Figures 2, 3 and 4
APPROPRIATE USE CRITERIA (AUC) FOR CORONARY REVASCULARIZATION UTILIZING CASES SUBMITTED TO THE NCDR® (National Cardiovascular Data Registry) CATHPCI REGISTRY®
*Carole Salamah, RN, ADN, Data Outcomes Specialist; *Jean Fleming, RN, BSBA, Health Care Improvement Coordinator; *Cecilia Lijauco, RN, MSN, Director of Health Care Improvement and Care Coordination; *Edward Bond, PhD, Database Analyst, Baylor Information Services (BIS); *Nancy Vish, RN, PhD, NEA-BC, FACHE, President and CNO; *Robert Stoler, MD, FACC, FSCAI, Director of the Cardiac Catheterization Lab
Baylor Jack and Jane Hamilton Heart and Vascular Hospital (BHVH), Dallas, Texas *No conflicts to disclose
Background
Objectives
Physician Progress Record
Article published in Journal of The American College of Cardiology (JACC) (1) regarding Appropriateness Criteria for Coronary Revascularization of about 180 frequent scenarios that were graded for appropriateness by a panel of physicians and surgeons.
Manesh R. Patel, Gregory J. Dehmer, John W. Hirshfeld, Peter K. Smith, and John A. Spertus ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography J. Am. Coll. Cardiol. 53:
Design and implement a method at BHVH that identifies “inappropriate” percutaneous coronary intervention (PCI) procedure based on the criteria presented in the JACC article and review the cases that are identified
Method
Multidisciplinary team formed
Physician Champions
Healthcare Improvement
ACC Data Analyst
Apollo/Lumedx Systems ® Administrator
Utilize current PCI data from software to abstract cases meeting the “inappropriate criteria based on JACC article
Educated Interventionalists on JACC article and posted tables in physician dictation area for review
Case review by the Medical Director of the Cath Lab: 8% of total PCI cases. After review, none required presentation to Cardiology Peer Review Committee
ACC generated AUC Beta Report reviewed and presented to Medical Leadership
Physician Progress Record updated for ease of documentation
Conclusion
JACC Appropriateness Figures 2, 3 and 4
Physician Education
Documentation for ACC elements will continue to be monitored and physicians trained
Self Auditing
Continue to monitor via self audits for “Inappropriate” categories with Director of Cath Lab
ACC Appropriate Use Criteria (AUC)
When available in 4th quarter 2010, will utilize the ACC outcomes report for Cardiology Peer Review (concentrating on the “inappropriate” category – to keep low)
Present Executive Outcomes report from ACC to the Leadership and Physician Cardiology Committees
BAYLOR HAMILTON HEART AND VASCULAR HOSPITAL OVERVIEW
Part of the Baylor Health Care System
Joint Venture
Connected to Baylor University Medical Center
Magnet Designation 2007
Total admissions for ,469
CathPCI Registry® submissions
With PCI procedures
ICD RegistryTM submissions
ACTION Registry®–GWTGTM submissions
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