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Prabhu KM, Don C, Sayre GG, Kearney KE, Hira RS, Waldo SW, Rao SV, Au DH, Doll JA. Interventional cardiologists' perceptions of percutaneous coronary intervention quality measurement and feedback. Am Heart J 2021; 235:97-103. [PMID: 33567319 DOI: 10.1016/j.ahj.2021.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/28/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Interventional cardiologists receive feedback on their clinical care from a variety of sources including registry-based quality measures, case conferences, and informal peer interactions. However, the impact of this feedback on clinical care is unclear. METHODS We interviewed interventional cardiologists regarding the use of feedback to improve their care of percutaneous coronary intervention (PCI) patients. Interviews were assessed with template analysis using deductive and inductive techniques. RESULTS Among 20 interventional cardiologists from private, academic, and Department of Veterans Affairs practice, 85% were male, 75% performed at least 100 PCIs annually, and 55% were in practice for 5 years or more. All reported receiving feedback on their practice, including formal quality measures and peer learning activities. Many respondents were critical of quality measure reporting, citing lack of trust in outcomes measures and poor applicability to clinical care. Some respondents reported the use of process measures such as contrast volume and fluoroscopy time for benchmarking their performance. Case conferences and informal peer feedback were perceived as timelier and more impactful on clinical care. Respondents identified facilitators of successful feedback interventions including transparent processes, respectful and reciprocal peer relationships, and integration of feedback into collective goals. Hierarchy and competitive environments inhibited useful feedback. CONCLUSIONS Despite substantial resources dedicated to performance measurement and feedback for PCI, interventional cardiologists perceive existing quality measures to be of only modest value for improving clinical care. Catherization laboratories should seek to integrate quality measures into a holistic quality program that emphasizes peer learning, collective goals and mutual respect.
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Affiliation(s)
| | - Creighton Don
- University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle, WA
| | | | | | | | - Stephen W Waldo
- University of Colorado School of Medicine, Aurora, CO; Department of Medicine, Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Sunil V Rao
- Department of Medicine, Duke University School of Medicine, Durham, NC; Durham VA Health Care System, Durham, NC
| | - David H Au
- University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle, WA
| | - Jacob A Doll
- University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle, WA.
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Naidu SS, Coylewright M, Hawkins BM, Meraj P, Morray BH, Devireddy C, Ing F, Klein AJ, Seto AH, Grines CL, Henry TD, Rao SV, Duffy PL, Amin Z, Aronow HD, Box LC, Caputo RP, Cigarroa JE, Cox DA, Daniels MJ, Elmariah S, Fagan TE, Feldman DN, Forbes TJ, Hermiller JB, Herrmann HC, Hijazi ZM, Jeremias A, Kavinsky CJ, Latif F, Parikh SA, Reilly J, Rosenfield K, Swaminathan RV, Szerlip M, Yakubov SJ, Zahn EM, Mahmud E, Bhavsar SS, Blumenthal T, Boutin E, Camp CA, Cromer AE, Dineen D, Dunham D, Emanuele S, Ferguson R, Govender D, Haaf J, Hite D, Hughes T, Laschinger J, Leigh SM, Lombardi L, McCoy P, McLean F, Meikle J, Nicolosi M, O'Brien J, Palmer RJ, Patarca R, Pierce V, Polk B, Prince B, Rangwala N, Roman D, Ryder K, Tolve MH, Vang E, Venditto J, Verderber P, Watson N, White S, Williams DM. Hot topics in interventional cardiology: Proceedings from the society for cardiovascular angiography and interventions 2020 think tank. Catheter Cardiovasc Interv 2020; 96:1258-1265. [PMID: 32840956 DOI: 10.1002/ccd.29197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/01/2020] [Indexed: 11/05/2022]
Abstract
The society for cardiovascular angiography and interventions (SCAI) think tank is a collaborative venture that brings together interventional cardiologists, administrative partners, and select members of the cardiovascular industry community for high-level field-wide discussions. The 2020 think tank was organized into four parallel sessions reflective of the field of interventional cardiology: (a) coronary intervention, (b) endovascular medicine, (c) structural heart disease, and (d) congenital heart disease (CHD). Each session was moderated by a senior content expert and co-moderated by a member of SCAI's emerging leader mentorship program. This document presents the proceedings to the wider cardiovascular community in order to enhance participation in this discussion, create additional dialogue from a broader base, and thereby aid SCAI and the industry community in developing specific action items to move these areas forward.
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Affiliation(s)
- Srihari S Naidu
- Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | | | - Beau M Hawkins
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | | | | | - Frank Ing
- UC Davis Medical Center, Los Angeles, California, USA
| | | | - Arnold H Seto
- Long Beach VA Health Care System, Long Beach, California, USA
| | - Cindy L Grines
- Northside Cardiovascular Institute, Atlanta, Georgia, USA
| | | | - Sunil V Rao
- Duke University Hospital, Durham, North Carolina, USA
| | - Peter L Duffy
- First Health Cardiology-Pinehurst, Pinehurst, North Carolina, USA
| | - Zahid Amin
- Children's Hospital of Georgia, Augusta, Georgia, USA
| | - Herbert D Aronow
- Lifespan Cardiovascular Institute/Brown Medical School, Providence, Rhode Island, USA
| | - Lyndon C Box
- West Valley Medical Center, Caldwell, Idaho, USA
| | | | | | - David A Cox
- Cardiovascular Associates, Birmingham, Alabama, USA
| | | | - Sammy Elmariah
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thomas E Fagan
- Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA
| | | | | | - James B Hermiller
- The St. Vincent Medical Group at The Heart Center, Indianapolis, Indiana, USA
| | - Howard C Herrmann
- University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Ziyad M Hijazi
- Weill Cornell Medical College, New York, NY. Sidra Medical and Research Center, Doha, Qatar
| | - Allen Jeremias
- St. Francis Hospital, The Heart Hospital, Roslyn, New York, USA
| | | | - Faisal Latif
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Sahil A Parikh
- New York Presbyterian/Columbia University Medical Center, New York, New York, USA
| | - John Reilly
- Stony Brook University Hospital, Stony Brook, New York, USA
| | | | | | | | - Steve J Yakubov
- OhioHealth Heart & Vascular Physicians, Coshocton, Ohio, USA
| | - Evan M Zahn
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ehtisham Mahmud
- University of California, San Diego Sulpizio Cardiovascular Center, San Diego, California, USA
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- Philips Healthcare, San Diego, California, USA
| | | | - Tico Blumenthal
- Cordis, A Cardinal Health Company, Santa Clara, California, USA
| | | | | | | | | | | | | | | | | | - Joel Haaf
- Philips Healthcare, San Diego, California, USA
| | - Denise Hite
- Cordis, A Cardinal Health Company, Santa Clara, California, USA
| | | | | | | | | | | | | | | | | | | | | | - Roberto Patarca
- Cordis, A Cardinal Health Company, Santa Clara, California, USA
| | | | - Bucky Polk
- Philips Healthcare, San Diego, California, USA
| | | | | | - Dana Roman
- Janssen Pharmaceuticals, Raritan, New Jersey, USA
| | - Ken Ryder
- Abiomed, Danvers, Massachusetts, USA
| | | | - Eric Vang
- Medtronic, Minneapolis, Minnesota, USA
| | | | - Paula Verderber
- Cordis, A Cardinal Health Company, Santa Clara, California, USA
| | - Nancy Watson
- Cordis, A Cardinal Health Company, Santa Clara, California, USA
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