ACC Quality Summit Posters Investigate Heparin Management During PCI, Same-Day Discharge After AFib Ablation, More
Award-winning posters presented during ACC Quality Summit 2022, Sept. 14-16, examined heparin management during PCI, the safety of same-day discharge for patients undergoing catheter ablation for atrial fibrillation (AFib), and the efficacy of universal high-dose hydration protocol on post-PCI serum creatinine. The ACC received over 80 poster submissions, and featured the top 25 at the exhibition during this year’s Summit.
The first-place poster, presented by Hussein Almadhoun, MD, RPh, MSc Clinical Pharm, from Ascension St. John Medical Center in Oklahoma, determines if a standardized approach to heparin management during cardiac catheterization could help prevent supratherapeutic anticoagulation. Almadhoun et al., found that implementation of a standardized approach, developed by a multidisciplinary Cath Lab Quality committee, reduced the rate of anticoagulation, helping the center meet the Michigan BMC2 Cardiovascular Consortium performance measure. Almadhoun notes that ACT > 350 seconds was seen in 27% of patients prior to implementation of the standardized recommendations. Once the new approach was adopted, it dropped to 12.2% of patients. Almadhoun concludes that opting for this standardized approach to anticoagulation management during PCI may help promote care efficiency and limit medications errors.
Sonal A. Patel, MMS, PA-C, of Rush University Medical Center in Illinois, received the second-place poster award for a research project looking into same-day discharge following catheter ablation for AFib. The study authors found that the implementation of same-day discharge for patients undergoing AFib ablation did not have a significant impact on outcomes, and helped ease hospital burden and costs during the COVID-19 pandemic. The study looked at 508 patients and compared complications, emergency department visits or hospitalizations of AFib ablations performed both pre-COVID and post-COVID. The results showed no statistically significant differences in the outcomes of same-day discharge post-COVID patients than with the pre-COVID cohort. Overall, Patel proposed same-day discharge for AFib ablation as a potentially beneficial protocol that should be studied further to confirm its safety.
Taking third place, Fathi Ali, MD, FACC, from the TriStar Southern Hills Medical Center, presented on if universal high-dose hydration protocol on post-PCI serum creatinine was safe and effective in reducing incidences of acute kidney injury (AKI). In April 2018, researchers implemented a high-dose hydration protocol for all PCI patients regardless of their risk for AKI. In doing so, Ali found that patients receiving the high-dose hydration treatment had a statistically significant down trends in creatinine post-procedure, indicating reduced AKI risk. Ali acknowledged that the study had limitations as it was conducted at a single center with a small sample size. He proposed a randomized controlled clinical trial should be the next step in confirming the benefits of this approach.
The People’s Choice Award, announced on the final day of the Summit, was awarded to Lydia Vincent, BSN, RN, and Melissa Mead, BSN, RN, of Eisenhower Medical Center in California, for their abstract on placing cardiac rehab (CR) referrals prior to acute myocardial infarction (AMI) discharge. Through the Accreditation Conformance Database Chest Pain Registry, researchers were able to identify a deficit with only 20% CR referral compliance. The abstract authors implemented an auto check feature on PCI orders which saw marked improvement, meeting their 50% CR referral compliance goal within one year and achieving an increase in CR enrollment (an average of 20 new patients monthly in 2020 and 30 new patients monthly in 2021). Vincent and Mead conclude that “interdisciplinary collaboration, education, auto checks and communication with providers has increased the compliance of placing CR referral prior to AMI discharge. This has increased participation in CR.”
In addition, three posters submitted to Quality Summit received honorable mentions:
- Care Transition Team Reduces Heart Failure Readmissions
Rush University Medical Center
- Application of Novel 1 Hour Troponin Algorithm in Risk Stratification of Patients Presenting With Chest Pain to the Strong Memorial Hospital Emergency Department
Kimberly M. Hsu, MD
University of Rochester
- Prevalence, Co-Morbidities and Treatment of Clinically-Defined Severe Familial Hyperlipidemias in Patients With Early CHD in a Local ACC NCDR PCI Registry
Danni Fu, MD
Lifespan CVI/Brown University
Clinical Topics: Anticoagulation Management, Arrhythmias and Clinical EP, COVID-19 Hub, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Anticoagulation Management and Atrial Fibrillation, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure
Keywords: Randomized Controlled Trials as Topic, Awards and Prizes, Illinois, Hospitals, Heparin, Heparin, Troponin, Referral and Consultation, Chest Pain, California, Algorithms, Heart Failure, Communication, Accreditation, Anticoagulants, Catheter Ablation, Acute Kidney Injury, Academic Medical Centers, Emergency Service, Hospital, Cardiac Catheterization, Myocardial Infarction, Risk Assessment, Registries, Universities, Sample Size, Prevalence, Pandemics, Oklahoma, Michigan, Longevity, Incidence, Hyperlipidemias, Goals, Georgia, COVID-19, Patient Transfer, Patient Readmission, Patient Discharge, Atrial Fibrillation, Percutaneous Coronary Intervention, Creatinine, Quality Improvement, Quality Summit, National Cardiovascular Data Registries
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