Impact of a Continuous Quality Improvement Committee on Outcomes for Patients Undergoing Percutaneous Coronary...

Continuous quality improvement (CQI) programs aim to enhance procedural safety and efficiency in percutaneous coronary intervention (PCI). This analysis evaluates changes in PCI practice patterns and outcomes after implementation of a multidisciplinary catheterization laboratory CQI committee at a large academic center.

A retrospective cohort study was conducted regarding PCI procedures from January 2018 to June 2024 using National Cardiovascular Data Registry CathPCI data. Outcomes and practice patterns were compared before (pre-CQI: 2018-October 2022) versus after CQI implementation (post-CQI: November 2022-2024). Prespecified primary end points were post-PCI acute kidney injury, periprocedural hemoglobin change, and same-day discharge.

Among 2759 PCI cases (1783 pre-CQI; 976 post-CQI), monthly PCI volume increased (30.7-48.2 cases/mo, P < .001). Post-CQI, radial access use increased (33.4%-58.9%, P < .001) and mean contrast volume decreased (188-153 mL, P < .001). Primary outcomes improved post-CQI: acute kidney injury decreased (14.3%-9.7%, P = .01), mean periprocedural hemoglobin change decreased (0.65-0.54 g/dL, P = .004), and same-day discharge increased (13.0%-24.7%, P < .001). Overall complication rates and in-hospital mortality remained stable.

Implementation of a catheterization laboratory CQI committee was temporally associated with improved PCI safety and discharge efficiency alongside increased procedural volume and evolving case mix. These findings support CQI-driven approaches to optimize PCI care delivery.