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Certain organic substances change color in dilute solution when the hydronium ion concentration reaches a particular value. For example, phenolphthalein is a colorless substance in any aqueous solution with a hydronium ion concentration greater than 5.0 × 10−9 M (pH < 8.3). In more basic solutions where the hydronium ion concentration is less than 5.0 × 10−9 M (pH > 8.3), it is red or pink. Substances such as phenolphthalein, which can be used to determine the pH of a solution, are...
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Improvement in quality indicators using NCDR® registries: First international experience.

Pedro Gabriel Melo de Barros E Silva1, Henrique Barbosa Ribeiro1, Renato Delascio Lopes2

  • 1Hospital TotalCor, São Paulo, Brazil.

International Journal of Cardiology
|June 5, 2018
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Summary

Utilizing the National Cardiovascular Data Registry (NCDR®) in Brazil improved cardiac care quality indicators for myocardial infarction (MI) and percutaneous coronary intervention (PCI) patients. This initiative demonstrated significant enhancements in key performance metrics over four years.

Keywords:
Cardiovascular diseaseDatabase management systemsQuality improvement

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Area of Science:

  • Cardiovascular Medicine
  • Health Services Research
  • Quality Improvement Science

Background:

  • The National Cardiovascular Data Registry (NCDR®) is a valuable tool for quality improvement in North America.
  • Its application and impact in other global regions remain largely unexplored.

Purpose of the Study:

  • To assess the effectiveness of NCDR® registries in guiding quality improvement initiatives at an international site.
  • To evaluate changes in key cardiovascular care indicators using NCDR® data.

Main Methods:

  • A Brazilian private cardiovascular hospital implemented the ACTION REGISTRY®-GWTG™ and CathPCI Registry® for myocardial infarction (MI) and percutaneous coronary intervention (PCI) patients.
  • Quarterly meetings discussed NCDR® reports, informing quality improvement initiatives and interventions.
  • Key indicators included door-to-ECG/balloon times, PCI appropriateness, length of stay, and guideline-based medication delivery.

Main Results:

  • 1,382 patients in ACTION REGISTRY®-GWTG™ and 3,179 in CathPCI Registry® were analyzed.
  • The AMI performance composite improved from 95.0% to 99.6% (p<0.001) over four years.
  • Appropriate/uncertain PCI rates increased from 91.1%/70.9% to 96.6%/84.7% (p<0.001).

Conclusions:

  • Implementing NCDR® registries as benchmarks for quality improvement in an international setting was successful.
  • This approach led to measurable improvements in critical quality indicators for cardiovascular care.