2022 Quality Summit ePosters (Non-CE) - CathPCI Registry-6. The Risky Business of High-Risk PCI: Selection, Timing, and Follow Through

6. The Risky Business of High-Risk PCI: Selection, Timing, and Follow Through

Pdf Summary

The document discusses the efforts made by Baylor Scott & White The Heart Hospital - Plano to improve their mortality outcomes for patients undergoing percutaneous coronary intervention (PCI). The baseline data from 2017Q3 showed that the hospital had a risk-adjusted mortality rate of 3.16%, placing them below the 50th percentile for US Hospital Performance.<br /><br />To address this issue, a team of interventional cardiologists, the Quality department director, and the CathPCI Registry® site manager conducted a review of the PCI mortalities occurring in 2017. The review identified several areas for improvement, including the need for better post-procedure care, follow-up for extended stay patients, standardized processes for evaluating transfer and surgical evaluation, and increased use of mechanical support.<br /><br />Based on these findings, the hospital implemented a multidisciplinary approach to high-risk team-based care throughout the hospital stay. This included the formation of a high-risk team, comprised initially of interventional cardiologists and thoracic surgeons, and later expanded to include heart failure and nephrology. The team developed a formalized review process for potential high-risk PCI cases and ensured that high-risk services were available 24/7.<br /><br />Other interventions included the creation of a high-risk PCI tool for evaluating transfers or inpatients prior to PCI, the development of a mechanical support algorithm, the implementation of palliative care consultations for high-risk PCIs and STEMI patients, and the establishment of regular meetings to review outcomes for STEMI cases.<br /><br />These interventions resulted in improved outcomes for patients, improved teamwork among disciplines, increased provider satisfaction, and decreased time for making practice changes. The hospital also created an internal PCI Scorecard for cardiologists and shared their tools and processes with their sister campuses.<br /><br />In conclusion, the multidisciplinary approach implemented by Baylor Scott & White The Heart Hospital - Plano resulted in a decrease in mortality and improved care for their high-risk PCI patients.

Keywords

Baylor Scott & White The Heart Hospital - Plano

mortality outcomes

percutaneous coronary intervention

risk-adjusted mortality rate

US Hospital Performance

post-procedure care

follow-up

mechanical support

high-risk team-based care

multidisciplinary approach