Process Standardization in High-Risk Coronary Interventions is Associated With Quality of Care Measures
Yvonne Heinen1, Georg Wolff, Kathrin Klein
1Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf, Germany. yvonne.heinen@med.uni-duesseldorf.de.
Insights
Process standardization using standard operating procedure (SOP) management in high-risk percutaneous coronary interventions (HR-PCIs) significantly reduced adverse events like bleeding and acute kidney injury. This approach also showed a trend toward shorter hospital stays, improving patient safety and care quality.
Area of Science:
- Cardiology
- Healthcare Quality Improvement
- Medical Procedure Optimization
Background:
- Patient safety is paramount in healthcare.
- High-risk percutaneous coronary interventions (HR-PCIs) are vital for complex coronary artery disease.
- The impact of process standardization on HR-PCI outcomes remained unclear.
Purpose of the Study:
- To evaluate the effect of standard operating procedure (SOP) management on HR-PCI outcomes.
- To assess improvements in patient safety and procedural efficiency.
- To compare in-hospital outcomes before and after SOP implementation.
Main Methods:
- Retrospective analysis of 192 patients undergoing HR-PCI at a German heart center.
- Comparison of outcomes between a group before SOP management (SOP (-) group, n=77) and after (SOP (+) group, n=115).
- Analysis of procedural characteristics, in-hospital outcomes, and length of stay.
Main Results:
- The SOP (+) group showed significantly lower rates of acute kidney events (7.0% vs 10.4%, P=.04) and bleeding (13.1% vs 31.2%, P<.01).
- A trend towards shorter length of hospital stay (9.3 vs 10.9 days, P=.10) and ICU stay (3.7 vs 4.7 days, P=.07) was observed in the SOP (+) group.
- SOP management was independently linked to shorter hospital stays via multivariate analysis.
Conclusions:
- Process standardization with SOP management significantly enhances quality of care in HR-PCIs.
- Implementation of SOPs leads to reduced adverse outcomes and shorter hospitalizations.
- SOP management is a valuable tool for improving patient safety in high-risk cardiovascular procedures.
Background:
Patient safety is one of the most important issues in healthcare. High-risk percutaneous coronary interventions (HR-PCIs) offer well-established treatment options for patients with complex coronary artery disease and multiple comorbidities. Whether process standardization using standard operating procedure (SOP) management and checklists improves HR-PCI is still unknown.
Methods And Results:
This retrospective study analyzed procedural characteristics, in-hospital outcomes, and length of hospital stay in patients who received HR-PCI in a German heart center 12 months before the introduction of process standardization using SOP management-the SOP (-) group-and after the introduction of process standardization using SOP management-the SOP (+) group. A total of 192 patients were included, with 77 patients in the SOP (-) group and 115 patients in the SOP (+) group. The mean age in the SOP (-) group was 72.0 ± 10.2 years and 81.8% were male; mean age in the SOP (+) group was 75.2 ± 10.4 years and 68.7% were male. Acute kidney events were significantly lower in the SOP (+) group than in the SOP (-) group (7.0% vs 10.4%; P=.04). Bleeding was the most common adverse event and significantly lower in the SOP (+) group than in the SOP (-) group (13.1% vs 31.2%, respectively; P<.01). There were trends toward shorter length of hospital stay in the SOP (+) group compared with the SOP (-) group (9.3 ± 6.4 days vs 10.9 ± 7.3 days, respectively; P=.10) and days of hospital stay in the intensive care unit (3.7 ± 4.0 days vs 4.7 ± 4.3 days; P=.07). SOP management was independently associated with shorter length of hospital stay in multivariate regression analysis.
Conclusion:
This retrospective study shows significantly better quality of care measures after the introduction of process standardization techniques using SOP management in HRPCIs, with a lower risk of adverse outcomes and shorter length of hospital stay.
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