1. Improvement in quality indicators using NCDR® registries: First international experience.
- Author
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de Barros E Silva PGM, Ribeiro HB, Lopes RD, Macedo TA, Conejo F, do Amaral Baruzzi AC, Okada MY, Garcia JCT, Rodrigues MJ, Furlan V, and Ribeiro EE
- Subjects
- Aged, Brazil epidemiology, Female, Hospital Mortality, Hospitalization statistics & numerical data, Humans, Length of Stay statistics & numerical data, Logistic Models, Male, Middle Aged, Registries statistics & numerical data, Risk Assessment, Risk Factors, Time-to-Treatment standards, Time-to-Treatment statistics & numerical data, Elective Surgical Procedures statistics & numerical data, Myocardial Infarction diagnosis, Myocardial Infarction epidemiology, Myocardial Infarction therapy, Percutaneous Coronary Intervention methods, Percutaneous Coronary Intervention statistics & numerical data, Quality Improvement organization & administration, Quality Indicators, Health Care standards
- Abstract
Background: The National Cardiovascular Data Registry (NCDR®) Database is commonly used for quality-improvement initiatives in North America, but little is known about the application of this tool in other regions of the world., Methods: All consecutive patients admitted due to myocardial infarction (MI) and/or undergoing percutaneous coronary intervention (PCI) from January 2012 until December 2015 in a Brazilian private cardiovascular hospital were included respectively in ACTION REGISTRY®-GWTG™ and CathPCI Registry®. Meetings including all hospital staff were performed quarterly to discuss every NCDR® report. Quality improvement initiatives were developed based on the reports which were also used for evaluation of changes after the interventions. The following indicators were considered a priority 1) Door-to-ECG and door-to-balloon (D2B) times; 2) PCI appropriateness; 3) length of stay; 4) delivery of guideline-based medication. Changes in the quality of care with respect to the over time were assessed using linear and logistic regression for continuous and binary outcomes, respectively., Results: A total of 1.382 patients were included in the ACTION REGISTRY®-GWTG™ and 3.179 patients in the CathPCI Registry®. In the ACTION registry, the overall AMI performance composite of quality indicators improved along the 4 years from 95.0% to 99.6% (p for trend <0.001). The percentage of appropriate/uncertain PCI in acute and elective scenario increased along the years from 91.1% and 70.9% to 96.6% and 84.7%, respectively (p for trend <0.001)., Conclusion: The present novel experience using the NCDR® registries as benchmarks to guide quality-improvement programs in an international site was associated with improvement in quality indicators., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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