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  • Quality in heart care

    The UK Gill Heart Institute’s team of physicians and specially trained nurses provides personal care while maintaining the highest clinical standards. 

    As a testament to these standards, in 2014 UK HealthCare was awarded the Get with the Guidelines-Resuscitation Gold Quality Achievement Award by the American Heart Association for using guidelines-based care to improve patient outcomes from in-hospital cardiac arrest. 

    Our goal is to provide every patient with exceptionally compassionate care in the safest and most appropriate manner possible based on the best evidence and the latest technological advances.


  • 1. Quality: overall PCI risk-adjusted mortality

    Overall-PCI-risk-adjusted-mortality  

    This graph shows the in-hospital death rate. Here, a lower number is better. It takes into account how sick the patient is. If a patient is older or has some serious health problems, the risk of death is higher. This compares our number to all U.S. hospitals reporting to the CathPCI Registry*.

    Some of the factors that affect a patient’s risk of death include:

    • Age. 
    • Body mass index. 
    • Diagnosis on admission and whether the patient arrives with symptoms of cardiogenic shock. 
    • Cardiac arrest or cardiac death that occurs outside of the hospital. 
    • Emergency of the procedure. 
    • Kidney function. 
    • Whether the patient has diabetes, heart failure, or chronic lung disease. 
    • Heart function and ejection fraction before the procedure. 
    • The number of diseased blood vessels. 

    2. Discharge medicines

    Discharge medicines chart

    This shows whether we prescribe the right medicines for our patients when they leave the hospital. A higher number is better. This compares our number to all U.S. hospitals reporting to the CathPCI Registry*.

    3. Door-to-balloon time

    median time to primary PCI

    This shows how quickly we treat our patients. It is the average time from a patient entering the hospital to getting PCI. A lower time is better. Our goal is to save the heart muscle. When we can open the artery fast, the patient will likely have a better outcome. It should lead to less heart damage, fewer complications, and higher survival rates. This chart compares our time to all U.S. hospitals reporting to the CathPCI Registry*.

    4. Appropriateness of PCI in 2013

    Appropriateness-of-PCI-procedures-in-2013 

    This shows if PCI was the right treatment for our patients. Here, a higher number is better. This compares our number to all U.S. hospitals reporting to the CathPCI Registry.

    The American College of Cardiology defines an appropriate PCI procedure. It should be:

    • An acceptable and reasonable treatment, and 
    • Likely to improve the patient’s health or survival. 

    The first graph shows procedures for patients with acute coronary syndrome or heart attack. This means the patients need treatment right away.

    The second graph shows planned procedures to non-acute coronary syndrome patients. These patients usually have stable angina, but some have unstable angina.

    There are 80 different factors we report to help show that PCI was the right treatment. These include:

    • Medical history. 
    • Medication therapy at home. 
    • Non-invasive studies: cardiac imaging and stress testing. 
    • Clinical presentation. 
    • Cardiac angiography findings and extent of the coronary artery disease. 

    5. Patient centeredness: radial access

    Radial access for PCI

    This measures whether we use radial access for our PCI treatments. This means we insert a tube in a wrist artery. This has many potential benefits for patients, such as:

    • Faster recovery. 
    • Same-day discharge from the hospital. 
    • Less pain. 
    • Less bleeding. 
    • Fewer complications. 

    The graph shows how the use of radial access has gone up.

    • In 2012, we used radial access for 18.9 percent of our PCI cases. This is compared to 15.3 percent of cases at all U.S. hospitals reporting to CathPCI Registry. 
    • In 2013, we used radial access in 43.2 percent of our PCI cases. This is compared to 20.3 percent of cases at all U.S. hospitals reporting to CathPCI Registry. 

    * Data Source: The American College of Cardiology’s CathPCI Registry® University of Kentucky Institutional Outcomes Report for years 2012 and 2013. The CathPCI Registry is the only nationwide outcomes-based quality improvement program for hospitals performing percutaneous cardiac intervention procedures. The Registry includes more than 1500 participating hospitals.

  • Heart attack care UK Healthcare - CM Heart Attack   

    PCI within 90 minutes of arrival 

    Oxygen is delivered to the heart via blood vessels. When one of those blood vessels becomes blocked, the heart muscle does not get enough oxygen and a heart attack may result. When this happens, restoring blood flow quickly can lessen damage to the heart. Percutaneous Coronary Interventions (PCIs) are one way doctors clear blockages to get blood flowing to the heart again. There are three procedures included in the term PCI. They are: 

    • Angioplasty – inflation of a balloon within the blood vessel 
    • Stenting – insertion of a wire tube to hold open the vessel 
    • Atherectomy – use of a blade or laser to cut through and clear the blockage  

    Aspirin at discharge 

    People who have had one heart attack are at high risk for another. Aspirin helps keep blood clots from forming and lowers the risk of another attack. (Note: Aspirin can have other negative side effects such as stomach inflammation; if you think you need an aspirin regimen, talk to your doctor first.)  

    Prescription for a statin at discharge  

    Statins are medications that lower cholesterol levels in the blood. Multiple clinical studies have shown that statin medications reduce the risk of repeat heart attacks and death in people who have had a heart attack.  

    About core measures

    Core measures are a set of evidence-based, scientifically researched processes or standards of care that are designed to improve outcomes for patients. Hospitals nationwide use these same core measures, which were established by the Center for Medicare & Medicaid Services (CMS) in 2000. Our goal is to provide this “best practice” care to all of our patients and to make sure it is documented accurately. By tracking our performance on these measures we can see how well we’re doing and identify areas that might need improvement.

  • Heart failure care

      UK Healthcare - CM Heart Failure 

    Patients given discharge instructions  

    Heart failure patients who leave the hospital with clear instructions on how to take care of themselves have better outcomes. These instructions include information on: 

    1. Diet  

    2. Medications  

    3. Appropriate level of activity  

    4. Follow-up appointments  

    5. Making sure to weigh themselves regularly  

    6. What to do if symptoms worsen 

     

    Patient given an evaluation of LVS function 

    The proper treatment for heart failure depends on what area of the heart is affected. A left ventricular systolic (LVS) function assessment tells the doctor how well the left side of the heart is pumping. 

    The assessment may include an echocardiogram, a physical examination, a chest x-ray, and/or blood work. 

    Patient given an ACE inhibitor or ARB for left ventricular systolic dysfunction 

    ACE inhibitors (angiotensin-converting-enzyme inhibitors) and ARBs (angiotensin II receptor blockers) are medications that block a hormone in the body that causes blood vessels to narrow. They help lower blood pressure and reduce how hard the heart needs to work. Heart failure patients who receive these medications have a significantly lower risk of death.  

     About core measures

    Core measures are a set of evidence-based, scientifically researched processes or standards of care that are designed to improve outcomes for patients. Hospitals nationwide use these same core measures, which were established by the Center for Medicare & Medicaid Services (CMS) in 2000. Our goal is to provide this “best practice” care to all of our patients and to make sure it is documented accurately. By tracking our performance on these measures we can see how well we’re doing and identify areas that might need improvement.
     

  • 2013 ICD Registry Data for UK HealthCare

    ICD stands for “implantable cardioverter-defibrillator.” A doctor places it under the skin. It has wires that run to the heart. They are used to:

    • Prevent death from cardiac arrest.
    • Help patients with heart rhythm problems.

    At UK HealthCare, we report placement data to the ICD Registry. This allows us to compare patient data with other hospitals nationally. It is also a measure of our quality of care.

    Below are three sets of data (metrics) on ICD patients.

    1. Was implanting an ICD appropriate for the patient?

    There are recommended guidelines for the use of ICDs. They are based on research. The guidelines weigh the benefits and risks of ICD placement. Here are the guidelines for appropriate treatment:

    • Class I: The benefits significantly outweigh the risks. ICD should be placed.
    • Class IIa: The benefits outweigh the risks. It is reasonable to place the ICD.
    • Class IIb: The benefits are equal to or greater than the risks. Placing an ICD may be considered.

    ICD illustration 1

    This graph shows the patients that received an ICD for classes I, IIa and IIb in 2013. A higher number is better. The average performance for U.S. hospitals reporting to ICD Registry is 91.5%. Our score is marked by the blue arrow.

    2. Were there complications after the placement?

    Risk-Adjusted Complications is a set of data that shows the number of deaths or related health problems for ICD patients. It looks at the time frame from implantation to discharge. The data takes into account each patient’s health problem.

    ICD illustration 2

    Here, a lower score is better. The average performance for U.S. hospitals reporting to ICD Registry is 1.51% Risk-Adjusted Complication rate. Our number is shown by the blue arrow. 

    3. Did the ICD patients get the right medicines?

    Studies show that ICD patients do better when they take the right medicines at home. Three medicines recommended for ICD patients are ACE inhibitors (angiotensin converting enzyme inhibitors), ARBs (angiotensin receptor blockers), and beta blockers. 

    ICD illustration 3

    This graph shows what part of the eligible patients receive these medicines on discharge. A higher number is better. This compares us to all U.S. hospitals reporting to the ICD Registry. The average performance for U.S. hospitals reporting to ICD Registry is 80.6%. Our number is shown by the blue arrow. 

    * Data Source: 

    The American College of Cardiology’s ICD Registry® University of Kentucky Institutional Outcomes Report for year 2013. The ICD Registry is the only nation wide outcomes-based quality improvement program for hospitals performing implantable cardioverter-defibrillator procedure. There were 1385 US Hospitals submitting data to the ICD Registry in 2013.


Page last updated: 12/9/2014 4:05:11 PM