Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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How to perfect cardiac cath peer review

by Jodi Askew April 27, 2016

The Society for Cardiovascular Angiography and Interventions (SCAI) has promoted cardiac cath peer review as an essential component of quality improvement for procedures like percutaneous coronary intervention (PCI), which has come under increasing scrutiny due to variation in utilization rates. SCAI has urged cath labs to establish methods for selected and random peer review, especially encouraging PCI programs to formalize ongoing peer review assessment of individual and aggregate outcomes against national and database benchmarks.

Programs that have followed suit have experienced substantial quality improvements. When East Carolina Heart Institute implemented a peer review processes for PCI cases by using its Cath PCI Registry database, the organization reduced inappropriate PCI for non-ACS by 73% in just one year.

Considering implementing at your organization? Read on to learn best practices for peer review in the cath lab, and how to implement a process at your organization.

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How much can your CV service line save from better observation care?

by Julie Bass March 29, 2016

Observation use has become increasingly common, growing over 96% since 2006. There are several potential drivers for this increase, including ambiguity in appropriateness of admission, concern over inpatient payment denials, and avoiding CMS readmission penalty.

While observation offers an opportunity for programs to identify the most appropriate treatment and care setting for a patient—avoiding unnecessary admissions—inefficient observation management can lead to excessive costs as well as patient dissatisfaction.

Optimizing observation services is particularly pertinent for CV programs, as over a quarter of observation cases are for CV-related issues. In fact, we calculated just how much hospitals can save by decreasing observation length of stay for common CV conditions—and it’s a lot.

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What remote patient monitoring means for heart failure

by Jodi Askew February 10, 2016

Now more than ever, cardiovascular service line leaders are expressing interest in deploying telemonitoring technology to remotely manage their CV patients. Remote patient monitoring, or RPM, enables providers to virtually collect and transmit a patient’s data for the purposes of clinical assessment and care management. The health care IT community is largely in agreement about RPM’s potential to expand the geographic reach, clinical scope, and capacity for quality care—isn’t it about time our CV service line leaders joined the conversation?

We say "yes." Just last year, our Health Care IT Advisor research team suggested that providers should deploy RPM for chronic disease patients. This has become more important in the last year, with mounting pressure from CMS and private payers to expand the timeframe for long-term accountable care management in the CV service line and escalating penalties associated with excess readmissions.

With this in mind, we examined the recent literature on the clinical and financial impacts of RPM for heart failure (HF) patients in five high-impact areas—length of stay, mortality, readmissions, cost effectiveness, and reimbursement—and have reported our most interesting findings below.

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Can PCI patients make it home for dinner? We say 'yes.'

Brian Contos February 3, 2016

Thanks to the two-midnight rule, Recovery Audit Contractors, and growing competition, hospitals face a lot of pressure to keep low-risk, short-stay patients out of inpatient beds. But when it comes to CV procedures like percutaneous coronary intervention (PCI), it’s a lot easier said than done. Findings from our Crimson Continuum of Care data set and Cardiovascular Roundtable research provide more insight into the opportunity for same-day discharge (SDD).

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How one hospital saved over $1,000 per case with LOS protocols

by Julie Bass January 13, 2016

Preliminary results from our 2015 CV Outpatient Efficiency Benchmarking Survey suggest that protocol-driven observation care leads significantly lower length of stays (LOS). In fact, the average observation LOS for chest pain patients is 41% lower for Cardiovascular Roundtable members who use chest pain protocols compared to members who do not.

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Improper ICD implants cost hospitals $250 million

by Julie Bass January 11, 2016

Five years ago, the Department of Justice (DOJ) started an investigation on the potential misuse of implantable cardioverter defibrillators (ICDs). In October 2015 the DOJ announced it had settled with 457 hospitals in 43 states for a total of $250 million for improper implantation of ICDs in Medicare patients.

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Need pre-admission testing done? Have the caregivers come to the patient.

by Marissa Schwartz January 5, 2016

Access is a buzzword throughout health care these days, and the CV service line is no exception. Improving patient access can differentiate your CV program—and a critical element of this is a flexible, convenient, and patient-focused schedule.

Here's how Elmhurst Memorial deployed dedicated CV schedulers and a streamlined scheduling process with promising results.

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How does your cath lab turnaround time compare?

by Kristen Barlow December 9, 2015

At the Cardiovascular Roundtable, we recently received a question on how long it takes to turn around a cath lab—in other words, the time between one patient leaving the room and the room being ready for the next case, not including scheduled down time—so we surveyed our members and received over 900 responses. Read on to learn about the survey results and how to improve your cath lab’s efficiency.

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