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Abstract
Problem Statement or Scientific Question: The National Cardiovascular Data Registry (NCDR) Chest Pain MI Registry metric Overall Defect free care for AMI at Discharge is not consistently being met by all 11 MH acute care hospitals. Process variation has been noted throughout the system with discharge medications: High Intensity Statins, P2Y12 inhibitors and Aspirin being the top 3 medications to not meet the metric. In order to meet the minimum requirements for an NCDR Silver Award for 2022, hospitals must have an overall defect free composite score of 65%.
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Problem Statement or Scientific Question: The National Cardiovascular Data Registry (NCDR) Chest Pain MI Registry metric Overall Defect free care for AMI at Discharge is not consistently being met by all 11 MH acute care hospitals. Process variation has been noted throughout the system with discharge medications: High Intensity Statins, P2Y12 inhibitors and Aspirin being the top 3 medications to not meet the metric. In order to meet the minimum requirements for an NCDR Silver Award for 2022, hospitals must have an overall defect free composite score of 65%.
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Overall Defect Free Care - System Journey to Improvement
Mrs. Michelle Wells
Affiliations:
null
null
Abstract
Problem Statement or Scientific Question: The National Cardiovascular Data Registry (NCDR) Chest Pain MI Registry metric Overall Defect free care for AMI at Discharge is not consistently being met by all 11 MH acute care hospitals. Process variation has been noted throughout the system with discharge medications: High Intensity Statins, P2Y12 inhibitors and Aspirin being the top 3 medications to not meet the metric. In order to meet the minimum requirements for an NCDR Silver Award for 2022, hospitals must have an overall defect free composite score of 65%.
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Problem Statement or Scientific Question: The National Cardiovascular Data Registry (NCDR) Chest Pain MI Registry metric Overall Defect free care for AMI at Discharge is not consistently being met by all 11 MH acute care hospitals. Process variation has been noted throughout the system with discharge medications: High Intensity Statins, P2Y12 inhibitors and Aspirin being the top 3 medications to not meet the metric. In order to meet the minimum requirements for an NCDR Silver Award for 2022, hospitals must have an overall defect free composite score of 65%.
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
Background/Project Intent: According to the AHA, patients have improved outcomes when taking cardiac medications post discharge. Utilizing the NCDR National Achievement Award results, Memorial Hermann Health System noted areas of opportunity with discharge medications to include High Intensity Statins, P2Y12 inhibitors and aspirin. A system project was implemented to improve results across the 11-hospital system.
Methodology: Robust Process Improvement methodology, which uses the Define, Measure, Analyze, Improve, Control (DMAIC) framework, was used to address correction of process failures and knowledge deficits. The following RPI tools were used: Define: Project Team Charter, Voice of the Customer, and Process Mapping; Measure: Data Collection via retrospective EHR reviews of discharge medication fallouts; Analyze: Identification of primary contributing factors for fallouts; Improve: Collaborative Team re-evaluation of policies/procedures and operational definitions with pertinent staff/physician education, physician alert at discharge: Control: Audit tool for process monitoring and sustainment. 1. Collaborative: A Multidisciplinary team evaluated the current DC medication process and created a future state process. 2. Review: Importance of physician order for DC meds or contraindication by discharge 3. Implement: A discharge medication alert for all patients that qualified for DC medications per NCDR CPMI standards if not already written 3. Education: Operational definitions, education via CV service line, and section meetings, HVI program directors, registry team. 4. Streamlined process to ensure NSTEMI patients without a procedure still received recommended DC medications.
Results: Once implemented, over a 3-month period, trending revealed a marked improvement in Overall Defect Free Care provided to patients, with focused improvement in High Intensity Statins, P2Y12, and ASA at discharge across the 11-hospital system. Results were taken from NCDR CPMI dashboard. While results varied within each hospital, an increase in Overall Defect Free care compliance went from 67.5% to 73.3% within 3 months of implementation. DC medication compliance with High Intensity Statin, P2Y12, and ASA improved overall to 95.8% within 3 months of implementation.
Value Proposition: By ensuring patients get the medications they need by discharge, patients experience better outcomes and streamlined continuity of care. This also leads to greater patient satisfaction
Conclusions: The National Cardiovascular Data Registry, directly impacts reporting of NSTEMI/STEMI outcomes and Chest Pain MI Registry risk stratification. Forming a multidisciplinary team that includes the voice of the customer, helps to ensure stakeholder buy in and increased success. Collaboration and communication is key to the success of any project.
References: NCDR CPMI Registry Dashboard and Reference Documents
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