Shared Best Practices
Shared practices from across our institutions can provide excellent ideas for improving your own work. This page is available to all Quality Improvement for Institutions facilities who are looking for tools, resources, and other quality improvement ideas from other facilities. The purpose of this site is to encourage and allow sharing of quality improvement tools, practices and processes developed by participants and used to improve care. Submitters are encouraged to provide materials that have evidence supporting their value. Have a best practice to share? Submit your shared facility practice. |
Shared Practice: Standardize Post-PCI Access Site Management
Post-PCI Bleeding
Indiana University Health, Indianapolis, IN
Standardizing the post-PCI access site management across 6 facilities, and improving the occurrence of reportable post-PCI vascular injuries.
PCI population
There were 4 resources included in the ACC Post-PCI Bleeding Risk Toolkit Pilot Study, all found within the PCI Bleeding Risk Toolkit:
- Competency: Arterial & Venous Sheath Removal (adopted at 4 facilities with the redeployment at the other two facilities with comparable competencies)
- Post PCI Sheath Removal Protocol (adopted by all 6 facilities)
- Post PCI Sheath Removal Checklist (adopted by 5 facilities)
- Risk Factors That Increase Vascular Complications After PCI (Informatics NLP solution adopted by four facilities on Cath Lab Structured reporting)
Comparing baseline CY 2016 to Q3 2017 there was an observed decrease in the number andpercentage of Post-PCI vascular injuries, as defined by the study. In addition to the improved outcomes, participation within the ACC Post-PCI Bleeding Risk Pilot Study further developed professional relationships within the organization across large geographic regions.
From an informatics usability perspective, our partnership with a vendor created an opportunity to data mine the Cath lab structured reporting database for internal analysis of internal data with those elements included within the “Risk Factors that Increase Vascular Complications After PCI.” This analysis provided insights to internal performance utilizing the knowledge of the NCDR Data Coordinator and the NLP within the vendor.
Creating and implementing quality improvement efforts can be difficult to develop adoption consensus across multiple providers and practice models. The ACC Quality Improvement Clinical Toolkit provides comprehensive documents for the quality improvement team to review for adopting. Once an opportunity is identified within the NCDR Registry, a review within the ACC Clinical Toolkit for improvement efforts, such as the Sheath Removal Checklist, can decrease the amount of time between identifying a potential problem and improving patient outcomes. Recruiting clinical professionals to abstract your NCDR data, and using those individuals for the expertise they can bring to improving outcomes has been successful for our organization.
Shared Practice: Reduce Post-PCI Bleeding Events
Post-PCI Bleeding
Memorial Health University Medical Center
Savannah, GA
The purpose of this project was to reduce post PCI bleeding events and ensure adherence to evidence based practice guidelines while promoting efficiency and improved patient outcomes.
The patient population for this project included all patients that had undergone PCI during their current hospital visit, excluding only patients that were directly transferred to the ICU from the cath lab.
Resources utilized in this project included tools found in the PCI Bleeding Risk Checklist, located in the ACC Clinical Toolkit: screening tool to identify risk factors for post-PCI complications, post PCI removal checklist, arterial and venous sheath removal competency, mandatory computer based learning on sheath removal, education to providers, along with weekly monitoring and updates on the utilization of the tools.
Validation of team member competencies, increased education and focus on PCI bleeding risks, and decreased bleeding events post-PCI.
- Engage key players and get buy in.
- Don't give up when met with resistance.
- Follow the process.