Improvement in quality indicators using NCDR® registries: First international experience
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. All consecutive patients admitted due to myocardial infarction (MI) and/or undergoin...
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| Veröffentlicht in: | International journal of cardiology 2018-09, Vol.267, p.13-15 |
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| creator | de Barros e Silva, Pedro Gabriel Melo Ribeiro, Henrique Barbosa Lopes, Renato Delascio Macedo, Thiago Andrade Conejo, Fabio do Amaral Baruzzi, Antônio Cláudio Okada, Mariana Yumi Garcia, Jose Carlos Teixeira Rodrigues, Marcelo Jamus Furlan, Valter Ribeiro, Expedito E. |
| description | 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.
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.
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 |
| doi_str_mv | 10.1016/j.ijcard.2018.05.102 |
| format | Article |
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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.
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).
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.
•National Cardiovascular Data Registry (NCDR®) is a well-known quality-improvement tool.•The utility of this tool in outside North America is unknown.•The report of an international site in NCDR showed an improvement in medical care.•The results indicate promising application of international registries in different countries.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2018.05.102</identifier><identifier>PMID: 29861104</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject><![CDATA[Aged ; Brazil - epidemiology ; Cardiovascular disease ; Database management systems ; Elective Surgical Procedures - statistics & numerical data ; Female ; Hospital Mortality ; Hospitalization - statistics & numerical data ; Humans ; Length of Stay - statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction - diagnosis ; Myocardial Infarction - epidemiology ; Myocardial Infarction - therapy ; Percutaneous Coronary Intervention - methods ; Percutaneous Coronary Intervention - statistics & numerical data ; Quality improvement ; Quality Improvement - organization & administration ; Quality Indicators, Health Care - standards ; Registries - statistics & numerical data ; Risk Assessment ; Risk Factors ; Time-to-Treatment - standards ; Time-to-Treatment - statistics & numerical data]]></subject><ispartof>International journal of cardiology, 2018-09, Vol.267, p.13-15</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-c66b088365b040231f52bb456b595bcc430b1915b0eef74cd74eed6a25937a0d3</citedby><cites>FETCH-LOGICAL-c362t-c66b088365b040231f52bb456b595bcc430b1915b0eef74cd74eed6a25937a0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2018.05.102$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29861104$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Barros e Silva, Pedro Gabriel Melo</creatorcontrib><creatorcontrib>Ribeiro, Henrique Barbosa</creatorcontrib><creatorcontrib>Lopes, Renato Delascio</creatorcontrib><creatorcontrib>Macedo, Thiago Andrade</creatorcontrib><creatorcontrib>Conejo, Fabio</creatorcontrib><creatorcontrib>do Amaral Baruzzi, Antônio Cláudio</creatorcontrib><creatorcontrib>Okada, Mariana Yumi</creatorcontrib><creatorcontrib>Garcia, Jose Carlos Teixeira</creatorcontrib><creatorcontrib>Rodrigues, Marcelo Jamus</creatorcontrib><creatorcontrib>Furlan, Valter</creatorcontrib><creatorcontrib>Ribeiro, Expedito E.</creatorcontrib><title>Improvement in quality indicators using NCDR® registries: First international experience</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>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.
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.
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).
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.
•National Cardiovascular Data Registry (NCDR®) is a well-known quality-improvement tool.•The utility of this tool in outside North America is unknown.•The report of an international site in NCDR showed an improvement in medical care.•The results indicate promising application of international registries in different countries.</description><subject>Aged</subject><subject>Brazil - epidemiology</subject><subject>Cardiovascular disease</subject><subject>Database management systems</subject><subject>Elective Surgical Procedures - statistics & numerical data</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Infarction - therapy</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Percutaneous Coronary Intervention - statistics & numerical data</subject><subject>Quality improvement</subject><subject>Quality Improvement - organization & administration</subject><subject>Quality Indicators, Health Care - standards</subject><subject>Registries - statistics & numerical data</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time-to-Treatment - standards</subject><subject>Time-to-Treatment - statistics & numerical data</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1OwzAQhS0EoqVwA4SyZJNiO3Z-WCChQqFSBRKCBSvLcSaVq_y0tlPRS3EIToZLCktWM5r53ozeQ-ic4DHBJL5ajvVSSVOMKSbpGHM_pQdoSNKEhSTh7BANPZaEnCbRAJ1Yu8QYsyxLj9GAZmlMCGZD9D6rV6bdQA2NC3QTrDtZabf1baGVdK2xQWd1swieJncvX5-BgYW2zmiw18FUG7sTOTCNdLptZBXAxwr8tlFwio5KWVk429cRepvev04ew_nzw2xyOw9VFFMXqjjOcZpGMc8xwzQiJad5znic84znSrEI5yQjfgtQJkwVCQMoYkl5FiUSF9EIXfZ3vY91B9aJWlsFVSUbaDsr6M50xGnGPcp6VJnWWgOlWBldS7MVBItdqGIp-lDFLlSBuZ9SL7vYf-jyGoo_0W-KHrjpAfA-NxqMsOong0IbUE4Urf7_wzdCnIt-</recordid><startdate>20180915</startdate><enddate>20180915</enddate><creator>de Barros e Silva, Pedro Gabriel Melo</creator><creator>Ribeiro, Henrique Barbosa</creator><creator>Lopes, Renato Delascio</creator><creator>Macedo, Thiago Andrade</creator><creator>Conejo, Fabio</creator><creator>do Amaral Baruzzi, Antônio Cláudio</creator><creator>Okada, Mariana Yumi</creator><creator>Garcia, Jose Carlos Teixeira</creator><creator>Rodrigues, Marcelo Jamus</creator><creator>Furlan, Valter</creator><creator>Ribeiro, Expedito E.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180915</creationdate><title>Improvement in quality indicators using NCDR® registries: First international experience</title><author>de Barros e Silva, Pedro Gabriel Melo ; 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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.
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).
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.
•National Cardiovascular Data Registry (NCDR®) is a well-known quality-improvement tool.•The utility of this tool in outside North America is unknown.•The report of an international site in NCDR showed an improvement in medical care.•The results indicate promising application of international registries in different countries.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>29861104</pmid><doi>10.1016/j.ijcard.2018.05.102</doi><tpages>3</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | International journal of cardiology, 2018-09, Vol.267, p.13-15 |
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| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Aged Brazil - epidemiology Cardiovascular disease Database management systems Elective Surgical Procedures - statistics & numerical data Female Hospital Mortality Hospitalization - statistics & numerical data Humans Length of Stay - statistics & numerical data Logistic Models Male Middle Aged Myocardial Infarction - diagnosis Myocardial Infarction - epidemiology Myocardial Infarction - therapy Percutaneous Coronary Intervention - methods Percutaneous Coronary Intervention - statistics & numerical data Quality improvement Quality Improvement - organization & administration Quality Indicators, Health Care - standards Registries - statistics & numerical data Risk Assessment Risk Factors Time-to-Treatment - standards Time-to-Treatment - statistics & numerical data |
| title | Improvement in quality indicators using NCDR® registries: First international experience |
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