New research presented Oct. 8 during ACC Quality Summit Virtual highlights best practices and lessons learned from hospitals participating in the College's Reduce the Risk: PCI Bleed campaign and the Patient Navigator Program.

Research from Jackson-Madison County General Hospital in Jackson, TN, a participant in Reduce the Risk: PCI Bleed, offers insights into decreasing in-hospital risk standardized post-PCI bleeding. Dylan Wilson, PharmD, et al., identified three factors associated with high-risk of bleeding in patients following PCI: 1) mynx closure device usage; 2) tirofiban usage; and 3) femoral arterial access. Based on these findings, the team created a PCI bleed avoidance strategy policy that integrated ACC's CathPCI Bleeding Risk Calculator into their electronic health record and ultimately helped to mitigate the three factors and decrease post-PCI bleeding risk.

At Mary Lanning Healthcare in Hastings, NE, Karen Woodward, RN, MHA, et al., conducted a study showing that rural community hospitals with low volume diagnostic heart catheterization can provide good quality care with low complications from cardiac catheterizations and PCI and maintain proficiency in the radial approach compared to larger facilities with high volumes. Results from the study showed PCI using radial access was performed 29.85% more than the average compared data groups, while PCI using femoral access was performed 29.46% less than the average compared data groups. As a result, there were fewer major adverse events in all PCI patients.

Improving patient engagement and ultimately outcomes and experience has been a critical component of ACC's overarching Patient Navigator Program. Research from eight hospitals participating in ACC's Patient Navigator: Focus MI quality campaign offered insights into several different ways to accomplish these goals.

Eleanor A. Rawls, MSN, APRN, et al., at WakeMed Health & Hospitals, Raleigh NC, conducted research showing that a patient-population specific nurse navigator as "captain of the ship" can impact patient engagement, contribute to lower readmissions and improve overall patient satisfaction. While studies by Kimberly W. Crout, MBA, BSN, RN, et al., at Atrium Medical Center, Middletown, OH, and Karen Avila, MSN, RN, et al., of Capital Health Medical Center-Hopewell, Pennington, NJ, highlighted the importance of multidisciplinary teams in ensuring efficient processes and open communication.

Cardiac rehabilitation (rehab) was also an area where Patient Navigators played important roles. Jerry Caldwell, RN, MSN, et al., at Baylor Scott and White Medical Center-Temple, Temple, TX, led a study showing that increasing the referral rate and the participation rate in outpatient cardiac rehab resulted in decreased risk of future cardiovascular-related events. Additionally, Stephanie Noeth, RN, et al., at Barnes-Jewish Hospital, Saint Louis, MO, showed that cardiac rehab improves quality of life and patient satisfaction, while also leading to a decrease in mortality and readmissions.

Other research, including a study by Gabriela Rivera-Camacho, MD, et al., at Atrium Health Carolinas Medical Center, Charlotte, NC, showed ways to improve value by decreasing unnecessary admissions, reducing the risk of major adverse cardiovascular events among patients who are discharged home, and decreasing health care costs. Jill Gall, BS, CCA, et al., from IU Health, Indianapolis, IN, addressed the need for an in-depth review of ACC's Chest Pain – MI Registry metric to create a standard process for the collection of troponin measurements and ensure consistent acute myocardial infarction care throughout the institution. Liliana B. Terziyska-Kuvlieva, MD, et al., from the University of Kentucky, Gill Heart and Vascular Institute, Lexington, KY analyzed how hospitals in ACC's Quality Campaigns and actively utilizing the NCDR registry outcomes reports, have significant success and are able to reach and sustain high performance.

Learn more and join ACC's Reduce the Risk: PCI Bleed at CVQuality.ACC.org. While the Patient Navigator Program has officially ended, hospitals can continue to access the tools and benefit from the lessons learned from participating institutions.

Clinical Topics: Cardiovascular Care Team, Invasive Cardiovascular Angiography and Intervention

Keywords: Quality Summit, National Cardiovascular Data Registries, CathPCI Registry, Chest Pain MI Registry, Patient Discharge, Patient Navigation, Cardiac Rehabilitation, Electronic Health Records, Hospitals, General, Hospitals, Community, Quality Improvement, Quality of Life, Outpatients, Percutaneous Coronary Intervention

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