A Good Thing or a Bad Thing in California?

The California Chapter of the American College of Cardiology (CAACC) is proposing that California hospitals voluntarily report PCI outcomes. The reporting consists of two sections: 1) In-house PCI patients’ risk-adjusted mortality (all patients); 2) Nineteen (19) data outcomes, reported in the quarterly Outcomes Report that the ACC provides to participating hospitals. Examples are:

• Proportion of elective PCIs with a positive stress or imaging study;
• Proportion of ST-elevation myocardial infarction (STEMI) patients receiving immediate PCI within 90 minutes;
• Median time to immediate PCI for STEMI patients (in minutes);
• Aspirin prescribed at discharge;
• Thienopyridine prescribed at discharge (patients with stents);
• Vascular access site injury requiring treatment or major bleeding (excluding coronary artery bypass graft surgery or other surgery during same admission).

The ACC is requesting that hospitals sign a participation agreement to have their Hospital Institutional Outcomes Report information reported on an annual basis on a website linked to CAACC.

I am curious about what reactions California facilities have seen from the interventional cardiologists about this proposal, and what those in other states think about this initiative. At my facility, the reactions have been mixed, with some thinking it is a great idea all the way across the spectrum to those who feel it should not be done and monitoring facilities’ outcomes should be an internal process only. Many of the cardiologists are still adjusting to the Appropriate Use Criteria the ACC has begun reporting in the Outcomes Reports which gives hospitals % of PCI procedures that were ‘appropriate’, ‘not appropriate’ or ‘uncertain’ in acute coronary syndrome (ACS) and non-ACS patients.

It was only a matter of time until hospitals would be asked to publically report percutaneous coronary intervention (PCI) outcomes. Although it is only voluntary reporting at this point in time, I feel it will evolve into being mandatory at some point in the future. Cardiac surgeons have been reporting their outcomes for many years now. What do you think?

If you would like to learn more about this proposal, visit the CAACC website below:

California Chapter of the American College of Cardiology
http://www.caacc.org [1]

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