2022 Quality Summit ePosters (Non-CE) - CathPCI Registry-15. Reducing Bleeding Risk and Unnecessary Transfusions for Patients Undergoing Percutaneous Coronary Interventions

15. Reducing Bleeding Risk and Unnecessary Transfusions for Patients Undergoing Percutaneous Coronary Interventions

Pdf Summary

The University of Cincinnati Medical Center conducted a quality improvement project to reduce bleeding and unnecessary transfusions during percutaneous coronary interventions (PCI). They collected patient data and conducted an in-depth chart review of bleeding and transfusion events. Various interventions were implemented, including the use of an EMR tool for bleeding risk calculation, education for providers, and participation in a campaign to reduce bleeding risk. The EMR was also used to create an auto-prompt for flagging non-emergent transfusions. Ongoing education and updates on best practices were provided to providers.<br /><br />The analysis showed that at least 35% of bleeding events were not related to access site or procedural complications, but rather to co-morbidities such as shock, trauma, and GI/GU sources. The authors acknowledged that the bleeding metric may not consider all comorbidities for severely ill complex patients treated at tertiary care centers.<br /><br />After implementing the interventions, there was a significant decrease in unnecessary transfusions, with the transfusion metric improving from 1.75 in Q4 of 2019 to 0.85 in Q2 of 2021. Similarly, the risk-adjusted bleeding metric improved from 3.64 to 2.15. Ongoing review of current practices is being conducted to sustain these improvements.<br /><br />Bleeding after PCI is a common complication that increases the risk of adverse outcomes. By improving bleeding and transfusion metrics, the authors aim to deliver quality care, reduce costs, and provide higher-value care.<br /><br />No financial or commercial disclosures were made by the authors.<br /><br />Figures 1 and 2 show the improvement in transfusion and bleeding metrics over time.

Keywords

University of Cincinnati Medical Center

quality improvement project

bleeding

transfusion

percutaneous coronary interventions

EMR tool

education for providers

comorbidities

adverse outcomes

cost reduction