Abstract
Co-authors: Laura Jensen, RN – Safety Coordinator, Quality, TMC Health; Jenna Wade, RRT – Cardiac Services Coordinator, CV Services, TMC Health
Laura Jensen, RN – Safety Coordinator, Quality, TMC Health; Jenna Wade, RRT – Cardiac Services Coordinator, CV Services, TMC Health Problem Statement or Scientific Question: At Tucson Medical Center (TMC), for the ACD registry, we had issues with obtaining ECGs with MD interpretation times.
Background/Project Intent: Q-Centrix has abstracted ACD data for Tucson Medical Center beginning in 2017. There were issues with MD interpretation times for ECGs for the ACD population. A new CV coordinator joined TMC in November of 2022, and collaboratively agreed with Q-Centrix that a process improvement for ECG interpretations was needed.
Methodology: Once we compared the volumes of missing metrics and targets for the ACD, we chose to focus on improving ECG interpretation times. Upon review of historical data, we identified approximately 40-50% of ECGs were missing MD interpretation times. We hold monthly meetings via Teams to discuss possible solutions to any missing documentation or metric fallouts. We discussed how the ECGs were being presented to the ER providers, was it delivered electronically to the provider or was the paper copy handed to the ER provider for interpretation. After discussion with Cardiac Services Coordinator and Clinical Services leader, it was determined that ECGs were delivered to the ER providers. The clinical services leader suggested the utilization of a stamp for ECGs that would prompt the ER provider to sign for interpretation time as used previously by the clinical services leader. The stamp was developed by the Cardiac Services Coordinator and Safety Coordinator and implemented in the ER. EKGs were stamped with date, time, STEMI/No STEMI, and spot for ER provider signature.
Results: Prior to implementation of the stamp utilization, in May of 2023, ECG interpretation was 20/44=45% compliance with the metric. Post implementation of the stamp data in July 2023, ECG interpretation was 42/44=95% compliance and December 2023 ECG interpretation was 44/45=97% compliance.
Value Proposition: The value proposition to this process change provided safer patient care and improving patient outcomes by allowing the ECGs to be adequately interpreted by an ER provider. Furthermore, the process changes for the ACD registry had an effect on the CPMI registry upgrade in early 2024 that requires the ECG interpretation times to be included in the data abstraction. This allowed TMC to meet the CPMI registry requirements by having implemented the stamp system prior to the upgrade and reduced cost in implementing a different process for the facility related to ECG tracking.
Conclusions: It is important for facilities to understand the methodology of ECG interpretation as it is essential that ECGs are read and interpreted accurately and timely. We identified the issue of missing documentation by implementing an effective process. This process goes beyond the ACD registry and can be utilized for CPMI. Additional data for CPMI can be obtained if chosen for e-poster.
References: ACC, NCDR
Laura Jensen, RN – Safety Coordinator, Quality, TMC Health; Jenna Wade, RRT – Cardiac Services Coordinator, CV Services, TMC Health Problem Statement or Scientific Question: At Tucson Medical Center (TMC), for the ACD registry, we had issues with obtaining ECGs with MD interpretation times.
Background/Project Intent: Q-Centrix has abstracted ACD data for Tucson Medical Center beginning in 2017. There were issues with MD interpretation times for ECGs for the ACD population. A new CV coordinator joined TMC in November of 2022, and collaboratively agreed with Q-Centrix that a process improvement for ECG interpretations was needed.
Methodology: Once we compared the volumes of missing metrics and targets for the ACD, we chose to focus on improving ECG interpretation times. Upon review of historical data, we identified approximately 40-50% of ECGs were missing MD interpretation times. We hold monthly meetings via Teams to discuss possible solutions to any missing documentation or metric fallouts. We discussed how the ECGs were being presented to the ER providers, was it delivered electronically to the provider or was the paper copy handed to the ER provider for interpretation. After discussion with Cardiac Services Coordinator and Clinical Services leader, it was determined that ECGs were delivered to the ER providers. The clinical services leader suggested the utilization of a stamp for ECGs that would prompt the ER provider to sign for interpretation time as used previously by the clinical services leader. The stamp was developed by the Cardiac Services Coordinator and Safety Coordinator and implemented in the ER. EKGs were stamped with date, time, STEMI/No STEMI, and spot for ER provider signature.
Results: Prior to implementation of the stamp utilization, in May of 2023, ECG interpretation was 20/44=45% compliance with the metric. Post implementation of the stamp data in July 2023, ECG interpretation was 42/44=95% compliance and December 2023 ECG interpretation was 44/45=97% compliance.
Value Proposition: The value proposition to this process change provided safer patient care and improving patient outcomes by allowing the ECGs to be adequately interpreted by an ER provider. Furthermore, the process changes for the ACD registry had an effect on the CPMI registry upgrade in early 2024 that requires the ECG interpretation times to be included in the data abstraction. This allowed TMC to meet the CPMI registry requirements by having implemented the stamp system prior to the upgrade and reduced cost in implementing a different process for the facility related to ECG tracking.
Conclusions: It is important for facilities to understand the methodology of ECG interpretation as it is essential that ECGs are read and interpreted accurately and timely. We identified the issue of missing documentation by implementing an effective process. This process goes beyond the ACD registry and can be utilized for CPMI. Additional data for CPMI can be obtained if chosen for e-poster.
References: ACC, NCDR
Co-authors: Laura Jensen, RN – Safety Coordinator, Quality, TMC Health; Jenna Wade, RRT – Cardiac Services Coordinator, CV Services, TMC Health
Laura Jensen, RN – Safety Coordinator, Quality, TMC Health; Jenna Wade, RRT – Cardiac Services Coordinator, CV Services, TMC Health Problem Statement or Scientific Question: At Tucson Medical Center (TMC), for the ACD registry, we had issues with obtaining ECGs with MD interpretation times.
Background/Project Intent: Q-Centrix has abstracted ACD data for Tucson Medical Center beginning in 2017. There were issues with MD interpretation times for ECGs for the ACD population. A new CV coordinator joined TMC in November of 2022, and collaboratively agreed with Q-Centrix that a process improvement for ECG interpretations was needed.
Methodology: Once we compared the volumes of missing metrics and targets for the ACD, we chose to focus on improving ECG interpretation times. Upon review of historical data, we identified approximately 40-50% of ECGs were missing MD interpretation times. We hold monthly meetings via Teams to discuss possible solutions to any missing documentation or metric fallouts. We discussed how the ECGs were being presented to the ER providers, was it delivered electronically to the provider or was the paper copy handed to the ER provider for interpretation. After discussion with Cardiac Services Coordinator and Clinical Services leader, it was determined that ECGs were delivered to the ER providers. The clinical services leader suggested the utilization of a stamp for ECGs that would prompt the ER provider to sign for interpretation time as used previously by the clinical services leader. The stamp was developed by the Cardiac Services Coordinator and Safety Coordinator and implemented in the ER. EKGs were stamped with date, time, STEMI/No STEMI, and spot for ER provider signature.
Results: Prior to implementation of the stamp utilization, in May of 2023, ECG interpretation was 20/44=45% compliance with the metric. Post implementation of the stamp data in July 2023, ECG interpretation was 42/44=95% compliance and December 2023 ECG interpretation was 44/45=97% compliance.
Value Proposition: The value proposition to this process change provided safer patient care and improving patient outcomes by allowing the ECGs to be adequately interpreted by an ER provider. Furthermore, the process changes for the ACD registry had an effect on the CPMI registry upgrade in early 2024 that requires the ECG interpretation times to be included in the data abstraction. This allowed TMC to meet the CPMI registry requirements by having implemented the stamp system prior to the upgrade and reduced cost in implementing a different process for the facility related to ECG tracking.
Conclusions: It is important for facilities to understand the methodology of ECG interpretation as it is essential that ECGs are read and interpreted accurately and timely. We identified the issue of missing documentation by implementing an effective process. This process goes beyond the ACD registry and can be utilized for CPMI. Additional data for CPMI can be obtained if chosen for e-poster.
References: ACC, NCDR
Laura Jensen, RN – Safety Coordinator, Quality, TMC Health; Jenna Wade, RRT – Cardiac Services Coordinator, CV Services, TMC Health Problem Statement or Scientific Question: At Tucson Medical Center (TMC), for the ACD registry, we had issues with obtaining ECGs with MD interpretation times.
Background/Project Intent: Q-Centrix has abstracted ACD data for Tucson Medical Center beginning in 2017. There were issues with MD interpretation times for ECGs for the ACD population. A new CV coordinator joined TMC in November of 2022, and collaboratively agreed with Q-Centrix that a process improvement for ECG interpretations was needed.
Methodology: Once we compared the volumes of missing metrics and targets for the ACD, we chose to focus on improving ECG interpretation times. Upon review of historical data, we identified approximately 40-50% of ECGs were missing MD interpretation times. We hold monthly meetings via Teams to discuss possible solutions to any missing documentation or metric fallouts. We discussed how the ECGs were being presented to the ER providers, was it delivered electronically to the provider or was the paper copy handed to the ER provider for interpretation. After discussion with Cardiac Services Coordinator and Clinical Services leader, it was determined that ECGs were delivered to the ER providers. The clinical services leader suggested the utilization of a stamp for ECGs that would prompt the ER provider to sign for interpretation time as used previously by the clinical services leader. The stamp was developed by the Cardiac Services Coordinator and Safety Coordinator and implemented in the ER. EKGs were stamped with date, time, STEMI/No STEMI, and spot for ER provider signature.
Results: Prior to implementation of the stamp utilization, in May of 2023, ECG interpretation was 20/44=45% compliance with the metric. Post implementation of the stamp data in July 2023, ECG interpretation was 42/44=95% compliance and December 2023 ECG interpretation was 44/45=97% compliance.
Value Proposition: The value proposition to this process change provided safer patient care and improving patient outcomes by allowing the ECGs to be adequately interpreted by an ER provider. Furthermore, the process changes for the ACD registry had an effect on the CPMI registry upgrade in early 2024 that requires the ECG interpretation times to be included in the data abstraction. This allowed TMC to meet the CPMI registry requirements by having implemented the stamp system prior to the upgrade and reduced cost in implementing a different process for the facility related to ECG tracking.
Conclusions: It is important for facilities to understand the methodology of ECG interpretation as it is essential that ECGs are read and interpreted accurately and timely. We identified the issue of missing documentation by implementing an effective process. This process goes beyond the ACD registry and can be utilized for CPMI. Additional data for CPMI can be obtained if chosen for e-poster.
References: ACC, NCDR
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