Background

1. Background Physician Progress Record Conclusion Method JACC Appropriateness Figures 2, 3 and 4 Objectives 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 • 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. SpertusACCF/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 TomographyJ. Am. Coll. Cardiol. 53: 530-553. 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 • 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 • 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 2010 -22,469 • CathPCI Registry® submissions 2010 -3700 • With - 1600 PCI procedures • ICD RegistryTM submissions 2010 - 470 • ACTION Registry®–GWTGTM submissions 2010 - 400 ADD OTHER HOSPITAL/ORGANIZATION LOGOS HERE