Prospective peer review of regional percutaneous interventional procedures: a tool for quality control and revalidation.

TitleProspective peer review of regional percutaneous interventional procedures: a tool for quality control and revalidation.
Publication TypeJournal Article
Year of Publication2012
AuthorsBlows LHJ, Dixon GF, Behan MWH, Allen R, Cohen AS, Dickinson K, Furniss S, Hatrick R, Hildick-Smith D, Holmberg S, Hyde JAJ, Kneale B, Lewis ME, Lloyd G, Patel NR, Pegge N, Signy M, Sulke NA, Trivedi U, Walker DM, de Belder AJ
JournalEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Volume8
Issue8
Pagination939-44
Date Published2012 Dec 20
Abstract

Aims: Current quality measures of percutaneous coronary intervention (PCI) procedures are based on the incidence of major adverse cardiac events (MACE). This crude marker ignores the many clinical nuances that make for sound decision making in PCI. We have established a prospective peer review audit tool to determine the quality of PCI within our cardiac network, which consists of five PCI hospitals serving a population of 1.4 million people in Sussex, UK. Methods and results: Analysis of 10% of all PCI cases selected at random each month by a non-clinical audit manager is made by a rotating panel of two PCI operators and one cardiac surgeon. Each PCI case is assessed for anatomical suitability, lesion severity, strategic appropriateness and final outcome. Panel findings were reported back to the operator and the audit manager. A total of 326 cases were assessed by the review committee. Results were disseminated to individual operators. Coronary anatomy and lesion severity were considered appropriate for PCI in 94.2% and 96.0% of cases, respectively. Appropriateness of strategy was confirmed in 86.2% and the outcome considered satisfactory in 90.8%. A total of 242 subsequent cases were analysed to assess practice trends. This analysis demonstrated a statistically significant improvement in clinical decision making with respect to appropriateness of strategy (from 86.2% to 92.6%; p=0.004). Conclusions: Prospective peer review of percutaneous coronary intervention cases by a rotating regional committee is valuable in ensuring procedural quality.

DOI10.1155/2013/951319
Alternate JournalEuroIntervention