on September 21, 2012 |
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Topics: Medical Cardiology, Cardiovascular, Service Lines, Risk Stratification, Methodologies, Performance Improvement, Readmissions, Quality
Nicole MacMillan, Cardiovascular Roundtable
The Roundtable frequently receives questions related to stratifying heart failure patients by risk of readmission, and about the various models and methods of implementation we have come across.
In light of impending HF readmission penalties beginning in October of this year, there is a clear focus among providers on lowering heart failure readmission rates to avoid paying fines of up to 1% of their base Medicare reimbursements. We have previously discussed the readmission penalty program.
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Risk stratification methods to reduce heart failure readmissions
on July 31, 2012 |
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Topics: Cardiovascular, Service Lines, CT, Imaging, Emergency Department, Risk Stratification, Methodologies, Performance Improvement, Technology Assessment, Cost and Productivity, Efficiency, Throughput
Megan Tooley, Cardiovascular Roundtable
As previously discussed in Cardiovascular Rounds, a number of recent studies have evaluated the overall costs and downstream impact of coronary CT angiography (CCTA) in various patient populations.
Adding to this list is the ROMICAT II (Rule Out Myocardial Infarction Using Computer Assisted Tomography) trial. The study assessed if using CCTA as a first diagnostic test in the emergency department (ED) to rule out acute coronary syndrome (ACS) in low-to-intermediate risk patients is more effective than standard evaluation.
The trial results, published in the New England Journal of Medicine on July 26, further validate the utility of CCTA as a safe alternative to nuclear imaging for certain patients presenting to the ED with chest pain. While overall costs, including all subsequent downstream services, were modestly higher in the CCTA group on average, the efficiency gains from a CCTA-based diagnostic strategy are promising.
Overall, more patients were discharged from the ED with fewer admissions to an observation unit among those receiving CCTA compared to standard evaluation.
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ROMICAT II: CCTA is safe and efficient in the ED, but not a cost cutter
on July 30, 2012 |
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Topics: Evidence-Based Practice, Methodologies, Performance Improvement, Cardiac Cath, Cardiovascular, Service Lines, Cardiac Surgery, Medical Cardiology
Nicole MacMillan, Cardiovascular Roundtable
Members have recently submitted several inquiries about guidelines, criteria, and clinical pathways for many cardiovascular conditions. The questions mainly surround heart failure, chest pain, atrial fibrillation, AMI/ PCI, and cardiac surgery.
Given the importance of standardizing CV operations across the care continuum and the growing concern over delivering the most appropriate treatments for patients, the Roundtable has compiled a number of helpful resources and sample CV pathways for our members' use.
We've collected three types of pathways organized by condition.
- Clinical guidelines
- Decision trees or patient pathways
- Triage criteria between observation units and admission to the ED
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Shedding light on cardiovascular practice guidelines, criteria, and pathways
