Cardiology 2013

Notes: Francis, Darrel P

eng

FS/10/38/28268/British Heart Foundation/United Kingdom

Observational Study

Netherlands

2012/01/31 06:00

Int J Cardiol. 2013 Jul 15;167(1):102-13. doi: 10.1016/j.ijcard.2011.12.018. Epub 2012 Jan 27.

URL: http://www.ncbi.nlm.nih.gov/pubmed/22285446

Author Address: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, 59-61 North Wharf Road, London W2 1LA, UK. d.francis@imperial.ac.uk

 

 

Reference Type:  Journal Article

Record Number: 377Author: Frederick, M. A., Singh, T., Salami, S., Oetgen, W. J. and Rosman, H. S.

Year: 2013

Title: First steps: exploring use of a prospective, office-based registry as the foundation for quality improvement in cardiology training

Journal: J Grad Med Educ

Volume: 5

Issue: 4

Pages: 694-9

Date: Dec

Short Title: First steps: exploring use of a prospective, office-based registry as the foundation for quality improvement in cardiology training

Alternate Journal: Journal of graduate medical education

ISSN: 1949-8349 (Print)

1949-8357 (Linking)

DOI: 10.4300/JGME-D-13-00057.1

PMCID: 3886477

Accession Number: 24455027

Abstract: BACKGROUND: Teaching practice-based learning and improvement and systems-based practice are challenging. Cardiology fellows at St John Hospital & Medical Center participate in a national registry of outpatient cardiology care. OBJECTIVE: We assessed the use of the registry, hypothesizing that it could serve as an effective foundation for studying ambulatory care, identifying gaps in care, and planning interventions to advance competence in practice-based learning and improvement and systems-based practice. METHODS: Starting in 2009, trainees prospectively entered data for ambulatory cardiac patients into the PINNACLE Registry database where compliance with 28 performance measures was calculated and reported quarterly. Fellows met with the program director individually and in groups to identify performance gaps and to develop and implement plans for quality improvement. Cardiology fellows were surveyed annually to assess this process. RESULTS: Through March 2012, the fellows had completed 2400 patient visits. Participation was feasible because it was cost neutral, with data form completion averaging 5 minutes. It was acceptable, with most fellows describing positive effects on practice-based learning and improvement without significant detriment to work flow. Performance achievement for drug therapies ranged from 69% (77 of 111) of the patients with atrial fibrillation receiving anticoagulation to 99% (486 of 489) of patients with coronary disease receiving lipid-lowering therapy. Gaps in system performance included low levels for diabetes screening (5%; 20 of 422) and lipid monitoring (10%; 58 of 573). Initial quality improvement projects addressed practice gaps with straightforward solutions. Improving system performance was more challenging. CONCLUSIONS: Using a registry in cardiology trainees’ outpatient practice is feasible, acceptable, and valuable. It allows for planning and studying the effects of quality improvement projects.

Pages: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208