Study finds room for improvement in angioplasty, shows what can be done to...( t he or she doesn't always make sure th...),Health

t he or she doesn't always make sure that patients scheduled for an angioplasty receive aspirin before their procedure, even though aspirin has been shown to reduce complications during and after angioplasty. Individual doctors may not realize how much their care differs from their colleagues at the same hospital, much less another hospital.

The BMC2 project helped hospitals and doctors understand just how they were doing on delivering key medications or reducing risks and to adopt practices that would help them improve.

For instance, the project's participants developed quick-reference tools that could be used to calculate how much dye was appropriate for each patient, or what their risk of suffering complications might be thereby allowing doctors and nurses to customize the treatment before, during and after that patient's angioplasty.

Each doctor and hospital in the study also received quarterly reports about how they measured up against the others in the project, on many different measures of preventive care, risk-reducing steps and outcomes. Regular meetings of participating clinicians, and visits by Moscucci and his team, helped all participants share results and plan new improvements. Each hospital team looked at their institution's own procedures and protocols and found new ways to make sure that patients didn't miss out on important medicines or face unnecessary risks.

While the data reported in the Circulation paper cannot show cause and effect because the hospitals were not randomized to the intervention or control groups, Moscucci and Share note that the association between the quality improvement project and the improvement in patient outcomes is strong. The effect was still statistically significant even after the data had been adjusted for patients' individual risk factors.

The project is especially relevant, they say, in light of the growing trend toward "pay for performance" incentives from insurers, and
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
10-Feb-2006

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