2022 Quality Summit ePosters (Non-CE) - CathPCI Registry-3. Utilizing National Cardiovascular Data Registry (NCDR® ) CathPCI Registry® Data to Drive Quality Improvement Efforts to Decrease Risk-Adjusted Acute Kidney Injury (AKI) and Improve Cardiac Rehab Referrals Post Percutaneous Coronary Intervention (PCI)

3. Utilizing National Cardiovascular Data Registry (NCDR® ) CathPCI Registry® Data to Drive Quality Improvement Efforts to Decrease Risk-Adjusted Acute Kidney Injury (AKI) and Improve Cardiac Rehab Referrals Post Percutaneous Coronary Intervention (PCI)

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Pdf Summary

The Parkview Heart Institute aimed to improve two metrics in their quality program: Metric 39 - PCI in-hospital risk-adjusted acute kidney injury (AKI) and Metric 45 - cardiac rehabilitation referral. They analyzed data from the National Cardiovascular Data Registry (NCDR®) CathPCI Registry® and found that both metrics were below the national average. They implemented measures to address these areas of improvement.<br /><br />For Metric 39, the hospital developed a plan to stabilize heart failure (HF) patients prior to heart catheterization (cath) by considering three factors: not taking hospitalized patients with acute HF to the cath lab unless necessary, delaying catheterization for patients on IV diuretics with rising creatinine until renal function stabilized, and performing the catheterization for HF patients after their creatinine stabilized off of IV diuretics but before starting certain medications. As a result, the risk-adjusted AKI rate dropped from 9.24 in 2019 to 6.43 in 2020 and remained consistent through 2021.<br /><br />For Metric 45, they updated the cath PCI order set to include a pre-checked referral to cardiac rehab. Compliance with cardiac rehab referral improved from 81.7% in Q4 2019 to 99.9% in Q4 2021.<br /><br />The results demonstrate the effectiveness of utilizing NCDR CathPCI registry data to drive process changes and improve patient outcomes. Physician leadership support, implementation of changes, transparency in data, and regular data sharing were identified as crucial factors in this improvement. The hospital plans to continue using the PCI order set to address other process metrics that are not yet at 100% compliance.<br /><br />Overall, this project showcases how data-driven quality improvement efforts can lead to positive changes in patient outcomes. By collaborating between general cardiologists and interventional cardiologists and utilizing the PCI order set, the hospital was able to decrease AKI incidence and achieve near-perfect referral rates to cardiac rehab.

Keywords

Parkview Heart Institute

Metric 39

PCI in-hospital risk-adjusted acute kidney injury

Metric 45

cardiac rehabilitation referral

National Cardiovascular Data Registry

NCDR CathPCI Registry

heart failure patients

risk-adjusted AKI rate

compliance with cardiac rehab referral