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Sep 23, 2013

Registry Program Sheds Light on Quality of Care

A report on data from the National Cardiovascular Data Registry highlights success stories and areas of improvement in cardiovascular care.

It’s important to set standards and best practices in the medical field, but how do we know if we’re meeting them? According to a new report, national registries that encompass more than 1.1 million patients provide important insight into improving outcomes and quality of care for patients with heart disease.

This report highlighted data from five of the American College of Cardiology’s National Cardiovascular Data Registry programs: the ACTION Registry-GWTG, CathPCI Registry, CARE Registry, ICD Registry and PINNACLE Registry. "The report provides a critical, national perspective on cardiac care and outcomes in both the in-patient and outpatient settings," said Frederick A. Masoudi, MD, MSPH, FACC, the Senior Medical Officer for the National Cardiovascular Data Registry. "In general, the report highlights the many improvements in quality of care that have occurred over the past three years, while also shedding light on areas where we can continue to improve."

Among the success stories, data from the CathPCI and ACTION registries showed continued improvements in treatment of heart attack patients. Guidelines recommend that heart attack patients requiring angioplasty—a lifesaving treatment for the most serious types of heart attack—receive treatment within 90 minutes of entering the hospital. The CathPCI and ACTION registries show that more hospitals are meeting these standards and treatment times continue to improve.

Also, the CathPCI registry shows that more doctors are employing a safer technique when performing angioplasty, where they insert a catheter through the arm or wrist instead of the leg. Use of this technique, called radial access, increased from 2.9% to 19.9% between 2009 and 2011, and rates continue to rise. "For patients in whom it's feasible, studies have shown lower bleeding rates and shorter recovery times with radial access," Masoudi said. "These data indicate uptake in this approach and are reflective of greater physician comfort with the procedure."

The fact that medications are being prescribed consistently is another mark of quality improvement success, according to Masoudi. Prescription of drugs that help lower blood pressure and cholesterol has increased between 2009 and 2011, and more patients receiving ICDs (implantable cardioverter defibrillator) to treat their irregular heartbeat are receiving the meds they need to reduce risk of complications.

But there’s plenty of room for improvement. One quarter of patients with ICDs are not receiving optimal therapy and nearly half of patients with atrial fibrillation, the most common type of irregular heartbeat, are not prescribed guideline-recommended drug therapy. Also, few patients with high blood pressure have a care plan and have managed to get their blood pressure under control.

Data from national registries has already proven useful in assessing quality of care for patients with heart disease and experts hope that this report will shed light on areas requiring improvement. It’s clear that we’ve made progress in improving outcomes and quality of care in recent years and the goal in healthcare is to provide the highest standard of care for each and every patient.

Questions for You to Consider

  • What is the American College of Cardiology's National Cardiovascular Data Registry?
  • The National Cardiovascular Data Registry (NCDR) is a data registry that helps hospitals and private practices measure and improve the quality of cardiovascular care they provide. The NCDR encompasses six hospital-based registries and one outpatient registry, making it the most comprehensive outcomes-based quality improvement program in the United States. With growing domestic and international participation, there are currently more than 2,400 hospitals and nearly 1,000 outpatient providers participating in NCDR registries.

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