2022 Quality Summit ePosters (Non-CE) - CathPCI Registry-2. Implementation of Radial First Approach and Use of Society for Cardiovascular Angiography & Interventions (SCAI) Risk Calculator Lead to Decrease in Bleeding Events and Mortality in Patients Post Percutaneous Coronary Intervention (PCI)

2. Implementation of Radial First Approach and Use of Society for Cardiovascular Angiography & Interventions (SCAI) Risk Calculator Lead to Decrease in Bleeding Events and Mortality in Patients Post Percutaneous Coronary Intervention (PCI)

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Pdf Summary

Utilizing data from the National Cardiovascular Data Registry (NCDR®) CathPCI Registry®, the Parkview Heart Institute identified higher bleeding outcomes and risk-adjusted mortality outcomes compared to the national average, along with lower radial access usage. To address these issues, they implemented quality improvement initiatives.<br /><br />The methodology involved implementing a "radial first" approach in the third quarter of 2020, where radial access was preferred for all cases unless contraindicated. The NCDR CathPCI data registry was used to track radial access usage and bleeding outcomes. Physician-level bleeding complications were monitored, and education was provided to physicians and nursing staff. Non-interventional cardiologists were also included in the communication and shared data from the registry.<br /><br />The results showed a significant improvement in radial access usage and a decrease in risk standardized bleeding rates. Prior to the project, radial access usage was 17.55%, which increased to 45% in Q4 2020 and reached a rolling four-quarter average of 54.71% in Q4 2021. Risk standardized bleeding rates decreased from 3.29 to 2.18 in Q4 2020 and further improved to 1.88 in Q4 2021, better than the 50th percentile within the registry.<br /><br />Additionally, the implementation of the Society for Cardiovascular Angiography & Interventions (SCAI) risk calculator contributed to a decrease in risk-adjusted mortality rates. The rate improved from 2.29 in Q4 2020 to 0.91 in Q4 2021, better than the 90th percentile within the registry.<br /><br />In conclusion, utilizing data from the NCDR CathPCI registry, the Parkview Heart Institute successfully implemented changes to increase radial access usage and improve patient outcomes. This was achieved through strong physician leadership support, data transparency, and communication with all interventional physicians. By decreasing bleeding rates, patient outcomes and satisfaction improved while reducing the cost of care.

Keywords

NCDR CathPCI Registry

Parkview Heart Institute

bleeding outcomes

radial access usage

quality improvement initiatives

physician-level bleeding complications

risk standardized bleeding rates

SCAI risk calculator

risk-adjusted mortality rates

physician leadership support