primary pci monitoring performance
DESCRIPTION
Primary PCI Monitoring Performance. Produced by Paul Arnold Clinical Quality Department. Date: 28 th June 2012 . Overview of the Performance Data. Primary PCI Pathway Activations (26 th Jan 09 – 30 th April 12). Service Total Overview. PPCI Pathway Activations (2953). n38. - PowerPoint PPT PresentationTRANSCRIPT
Primary PCI Monitoring Performance
Produced by Paul Arnold Clinical Quality Department
Date: 28th June 2012
Overview of the Performance Data
Primary PCI Pathway Activations (26th Jan 09 – 30th April 12)
PPCI Pathway Activations (2953)
Service Total Overview
Incorrect use of Pathway x38
Correct use NO PPCI x 141
All genuine activations
All suspected MI cases Managed as PPCI
To unwell to perform x 6procedure Other x 2Early death x 1Patient refuse consent x 2
Angiography performed Not an MI – NO PCI x 340
NON- PPCI (827)
n38
n611Incorrect activations x 120
n480
n491
TBC n37
PCI attempted (2126)
n141
n120
n11
n340
N752
Overview of the Performance Data
Primary PCI Pathway Activations (26th Jan 09 – 30th April 12)
PPCI Pathway Activations (2953)
Service Total Overview
Potential culprit lesion
confirmed
Surgical disease x 68PCI not indicated – x 54Occlusion small vesselPCI indicated but x 7Not possible/ attempted TO unwell to perform PCI x 7Early Deaths x 4
PCI procedure attempted
PCI failed(55)
PCI partial success(68)
TIMI 3(1989, 94%)
TBC (14)
n140 n140
N2126
Contents
Data Review 26.01.09 – 30.04.12
• 2953 Primary PCI pathway activations identified. Of which, 71.9% (2126/ 2953) had a PPCI.
• Overview of the Performance Data– Service Total Overview– Admission Source – PPCI activations– Onset of Pain > 999 Call– Diagnostic ECG analysis– CTB analysis– DTB analysis – PPCI Success Rate– Summary Statistics by Consultant – Mortality rate
• Discussion• Thanks
Admission Source
Key Summary Statistics
887, 45%1079, 55%
Transfers
Directs
n1966NB:160 Inter-hospital INP are excluded as part of MINAP CTB criteria
Key Summary Statistics
Call or Self-Present Balloon
Primary PCI: Call-to-Balloon
Key Summary Statistics
Primary PCI: Activations (Jan 2010 - Dec 2011)
Key Summary Statistics
Primary PCI: Overall CTB Time Performance (Jan 2009 – Apr 2012)
n1966Median 104mins
Key Summary Statistics
Primary PCI: Call-to-Balloon 120 Yearly Performance
Median 104mins n1966
Key Summary Statistics
Primary PCI: Call-to-Balloon Time Performance (Jan 2009 – Apr 2012)
Median 104mins n1966
Key Summary Statistics
Primary PCI: Call-to-Balloon 150 Yearly Performance
Median 104mins n1966
Key Summary Statistics
Overall Success Call-To-Balloon (Target 120mins)
Median 104mins National target 150minutes CTB (80.5% compliant) n1966
Key Summary Statistics
Direct Success Call-To-Balloon (Target 120mins)
Median 89mins n1079National target 150minutes CTB (98.4% compliant)
Key Summary Statistics
Inter-Hospital Transfer Success Call-To-Balloon (Target 120mins)
n887Median 140mins National target 150minutes CTB (59% compliant)
Key Summary Statistics
Onset of pain to 999 Call
Key Summary Statistics
Interval between AED admission to diagnosed ECG
Key Summary Statistics
Interval between diagnosed ECG and PPCI activation
Key Summary Statistics
Median Interval between transfers > Inter-Hospital Transfers
Key Summary Statistics
LHCH -> Balloon
LHCH Door Balloon
Key Summary Statistics
Overall patients treated within DTB Target 90mins
Median 33mins N2126
Key Summary Statistics
3%
2%
1%
94%
Complete success
Partial success
Unsuccessful NeutralOutcome
Unsuccessful AdverseOutcome
TBC
Success of PPCI
N2126
Summary Statistics by Consultant
Key Summary Statistics
No. of casesComplete
Success % MortalityAndron 83 98 2 2.4%
Appleby 63 98 3 4.7%
Khand 64 86 2 3.1%
Mills 250 94 11 4.4%
Morris 252 94 10 3.9%
Morrison 267 95 7 2.6%
Palmer 291 95 12 4.1%
Perry 264 93 10 3.7%
Stables 259 92 8 3.0%
Ramsdale 193 93 5 2.5%
Velavan 135 96 3 2.2%
Fisher 4 100 - 0% N2126
Key Summary Statistics
Length of Stay on CCU
Key Summary Statistics
Average Length of Stay on CCU (Target 12 hours)
N2126
Key Summary Statistics
Total Length of Stay in Hospital
Key Summary Statistics
Total Length of Stay (Target 72 hours)
BOX = Inter Quartile Range & Whiskers = Min & Max N2126
72 7681
66 6975 72 72 69 72 72 71
142
101
131
8392
115
93102 103 101
92100
0
20
40
60
80
100
120
140
160
180
200
Appleby Andron Khand Mills Morris Morrison Palmer Perry Ramsdale Stables Velavan Allconsultant
LOS
in H
ours
1st Quartile Upper Limit Median Average Lower Limit 3rd Quartile
2539 839 766 720 253921831709 6261466636 2087676
Key Summary Statistics
In-Hospital Mortality in STEMI Inpatients admitted for Primary PCI
Key Summary Statistics
In-Hospital Mortality in Patients that Underwent a Primary PCI
IHM > National average 4.4%
Key Summary Statistics
30-day Mortality in Primary PCI Activations
Key Summary Statistics
30-Mortality in Patients that Underwent a Primary PCI
30 day Mortality National Average 5.7%
Any Questions