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					                                                              APPROPRIATE USE CRITERIA (AUC) FOR CORONARY REVASCULARIZATION
                                                              UTILIZING CASES SUBMITTED TO THE NCDR® (National Cardiovascular Data
                                                                                 Registry) CATHPCI REGISTRY®
 *Carole Salamah, RN, ADN, Data Outcomes Specialist; *Jean Fleming, RN, BSBA, Health Care Improvement Coordinator; *Cecilia Lijauco, RN, MSN, Director of Health Care Improvement and Care Coordination; *Edward
       Bond, PhD, Database Analyst, Baylor Information Services (BIS); *Nancy Vish, RN, PhD, NEA-BC, FACHE, President and CNO; *Robert Stoler, MD, FACC, FSCAI, Director of the Cardiac Catheterization Lab
                                                                   Baylor Jack and Jane Hamilton Heart and Vascular Hospital (BHVH), Dallas, Texas                                        *No conflicts to disclose

                           Background                                                           Objectives                                                          Physician Progress Record

      Article published in Journal of The American
      College of Cardiology (JACC) (1) regarding                           Design and implement a method at BHVH that
      Appropriateness Criteria for Coronary                                identifies “inappropriate” percutaneous coronary
      Revascularization of about 180 frequent scenarios                    intervention (PCI) procedure based on the criteria
      that were graded for appropriateness by a panel of                   presented in the JACC article and review the
      physicians and surgeons.                                             cases that are identified

      1. Manesh R. Patel, Gregory J. Dehmer, John W. Hirshfeld,
         Peter K. Smith, and John A. Spertus
         Appropriateness Criteria for Coronary
         Revascularization: A Report by the American College of                                  Method
         Cardiology Foundation Appropriateness Criteria Task
         Force, Society for Cardiovascular Angiography and
         Interventions, Society of Thoracic Surgeons, American
         Association for Thoracic Surgery, American Heart                   •Multidisciplinary team formed
         Association, and the American Society of Nuclear
         Cardiology Endorsed by the American Society of                       •Physician Champions
         Echocardiography, the Heart Failure Society of America,              •Healthcare Improvement
         and the Society of Cardiovascular Computed Tomography                •ACC Data Analyst
         J. Am. Coll. Cardiol. 53: 530-553.
                                                                              •Apollo/Lumedx Systems ® Administrator
                                                                            •Utilize current PCI data from software to
                                                                            abstract cases meeting the “inappropriate criteria   JACC Appropriateness Figures 2, 3 and 4

          BAYLOR HAMILTON HEART AND                                         based on JACC article                                                                                         Physician Education
          VASCULAR HOSPITAL OVERVIEW                                        •Educated Interventionalists on JACC article and                                                               Documentation for ACC elements will
     Part of the Baylor Health Care System                                 posted tables in physician dictation area for                                                                  continue to be monitored and physicians
     Joint Venture                                                         review                                                                                                         trained
     Connected to Baylor University Medical Center                         •Case review by the Medical Director of the Cath                                                              Self Auditing
     Magnet Designation 2007                                               Lab: 8% of total PCI cases. After review, none                                                                 Continue to monitor via self audits for
     Total admissions for 2010 - 22,469                                    required presentation to Cardiology Peer Review                                                                “Inappropriate” categories with Director of
       CathPCI Registry® submissions 2010 - 3700                            Committee                                                                                                      Cath Lab
         With - 1600 PCI procedures                                         •ACC generated AUC Beta Report reviewed and                                                                   ACC Appropriate Use Criteria (AUC)
       ICD RegistryTM submissions 2010 - 470                                presented to Medical Leadership                                                                                When available in 4th quarter 2010, will
       ACTION Registry®–GWTGTM submissions                                  •Physician Progress Record updated for ease of                                                                 utilize the ACC outcomes report for
       2010 - 400                                                           documentation                                                                                                  Cardiology Peer Review (concentrating on the
                                                                                                                                                                                           “inappropriate” category – to keep low)
                                                                                                                                                                                           Present Executive Outcomes report from
                                                                                                                                                                                           ACC to the Leadership and Physician
                                                                                                                                                                                           Cardiology Committees


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