Implementation of a continuous quality improvement program for percutaneous coronary intervention and cardiac surgery at a large community hospital.

John E Brush; Sharmini A Balakrishnan; Joani Brough; Carl Hartman; Grace Hines; Deborah P Liverman; John P Parker; Jeffrey Rich; Nancy Tindall

doi:10.1016/j.ahj.2005.12.014

PubMed · 16875926

Implementation of a continuous quality improvement program for percutaneous coronary intervention and cardiac surgery at a large community hospital.

John E Brush·Sharmini A Balakrishnan·Joani Brough·Carl Hartman·Grace Hines·Deborah P Liverman·John P Parker·Jeffrey Rich·Nancy Tindall

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Abstract

BACKGROUND: Continuous quality improvement (CQI) is widely used in other industries and has been promoted as a method for quality control in medicine. The national databases developed by the American College of Cardiology and the Society of Thoracic Surgeons have greatly facilitated data collection for CQI. Hospitals can encounter barriers to CQI, however, which include creating the proper organizational infrastructure and engaging physicians and hospital administrators in the process. These barriers are particularly evident in large community hospitals. METHODS: We describe the organizational infrastructure for CQI, including committee structure, methods of repeated data collection and feedback, and maintenance of data integrity and confidentiality. We report demographic data and clinical outcomes for patients undergoing percutaneous coronary intervention and coronary artery bypass surgery before and after implementation of our CQI program. RESULTS: Since 1995, we have maintained a CQI process driven by repeated collection of valid, confidential, operator-specific data. We have observed sustained physician and administration participation and buy-in. During the follow-up period, patient complexity increased and observed outcomes improved, although the improvement was clearly multifactorial. CONCLUSIONS: We describe the organization of a CQI program at a large complex community hospital. Our CQI program was successfully implemented, has been sustained, and is associated in observed improvement in patient outcomes. The program described here may be a useful model for other similar hospitals that are attempting to create a program to address quality improvement.

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Aged Angioplasty, Balloon, Coronary Confidentiality Coronary Artery Bypass Data Collection Female Hospital Mortality Hospitals, Community Humans Internal Mammary-Coronary Artery Anastomosis Male Outcome Assessment, Health Care Program Development Total Quality Management Virginia Journal Article

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John E Brush, Sharmini A Balakrishnan, Joani Brough, Carl Hartman, Grace Hines, Deborah P Liverman, John P Parker, Jeffrey Rich, Nancy Tindall. 2006. Implementation of a continuous quality improvement program for percutaneous coronary intervention and cardiac surgery at a large community hospital.. https://doi.org/10.1016/j.ahj.2005.12.014

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