Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Jan 2013
Multicenter StudyProphylaxis against venous thromboembolism in hospitalized medically ill patients.
Many hospitalized medically ill patients are at risk of venous thromboembolism (VTE). Risk factors include prior VTE, older age, immobility, obesity, cardiac or respiratory failure, and cancer (at-risk patients). Although guidelines recommend use of VTE prophylaxis for at-risk patients, many may not receive it. ⋯ The majority of at-risk hospitalized medically ill patients do not receive VTE prophylaxis.
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Circ Cardiovasc Qual · Jan 2013
Primary care provider receipt of cardiac rehabilitation discharge summaries: are they getting what they want to promote long-term risk reduction?
Communication between cardiac rehabilitation (CR) and primary care providers (PCPs) is paramount to promoting long-term risk reduction after the completion of CR. The objectives of this study were to investigate receipt of CR discharge summaries by PCPs, as well as timing, and satisfaction with and perceptions of CR summaries. ⋯ Approximately half of CR discharge summaries reach PCPs, revealing a large gap in continuity of patient care.
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Circ Cardiovasc Qual · Jan 2013
Statistical methods to monitor risk factors in a clinical database: example of a national cardiac surgery registry.
Comparison of outcomes requires adequate risk adjustment for differences in patient risk and the type of intervention performed. Both unintentional and intentional misclassification (also called gaming) of risk factors might lead to incorrect benchmark results. Therefore, misclassification of risk factors should be detected. We investigated the use of statistical process control techniques to monitor the frequency of risk factors in a clinical database. ⋯ Statistical process control in the form of a Shewhart control chart, exponentially weighted moving average, and cumulative sum charts provide a means to monitor changes in risk factor frequencies in a clinical database. Surveillance of the overall expected risk in addition to the separate risk factors ensures a high sensitivity to detect gaming. The use of statistical process control for risk factor surveillance is recommended.
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Circ Cardiovasc Qual · Jan 2013
Multicenter StudySurvival trends in pediatric in-hospital cardiac arrests: an analysis from Get With the Guidelines-Resuscitation.
Despite ongoing efforts to improve the quality of pediatric resuscitation, it remains unknown whether survival in children with in-hospital cardiac arrest has improved. ⋯ Rates of survival to hospital discharge in children with in-hospital cardiac arrests have improved over the past decade without higher rates of neurological disability among survivors.
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Circ Cardiovasc Qual · Jan 2013
Multicenter Study Comparative StudyAchievement of guideline-concordant care and in-hospital outcomes in patients with coronary artery disease in teaching and nonteaching hospitals: results from the Get With The Guidelines-Coronary Artery Disease program.
Secondary prevention therapies improve longitudinal outcomes in patients with coronary artery disease. Previous studies showed that teaching hospitals (THs) more consistently use evidence-based secondary prevention therapies than non-THs (NTHs). It is unclear whether these differences persist after initiation of a national quality improvement system. ⋯ Adherence to guideline-recommended therapies increased over time with participation in the Get With The Guidelines-Coronary Artery Disease program, regardless of the teaching status. Guideline-concordant care over the full decade was higher in THs; however, NTHs demonstrated greater incremental improvement over time.