What is Percutaneous Coronary Intervention (PCI)?
It is commonly known as stenting, a minimally invasive medical procedure used to treat blocked or narrowed coronary arteries. During PCI, a thin catheter is inserted through a blood vessel, typically in the groin or wrist, and guided to the site of the blockage. A small balloon at the tip of the catheter is inflated to widen the artery and improve blood flow. In many cases, a stent (a tiny metal scaffold) is also placed to help keep the artery open, reducing the risk of future blockages.
Why is PCI done?
PCI is performed to relieve symptoms of coronary artery disease, such as chest pain, and to prevent heart-related complications.
Value-Based Health Care Benefits
Patients
- Lower costs
- Better outcome
Providers
- Higher patient satisfaction rates
- Better care efficiencies
Payors
- Stronger cost controls
- Reduced risks
Society
- Reduced healthcare expenses
- Better overall health
What are Value Driven Outcomes?
Value Driven Outcomes is a simple concept of improving care for patients with an aim to drive down costs. With its fundamental factors based on overall patient wellness and preventive measures, reaching this goal is based on a set of adjustments in how patients receive medical treatment. Overall wellness, quality of care, and preventive screenings all are taken into consideration, ultimately resulting in better healthcare outcomes.
In Pantai Hospital Kuala Lumpur, we are aiming to make healthcare proactive rather than reactive, preventing problems from occurring before they start. In view of that, we had designed a Value Driven Outcomes (VDO) framework for Percutaneous Coronary Intervention (PCI), in which pre-set quality indicators were used to determine cost rationalisation.
PCI Quality Indicators (benchmarks)
- Aspirin, Thienopyridines, Statins prescribed at discharge
This metric assesses the ideal post-procedure medical treatment, which involves prescribing aspirin, thienopyridines, and statins to patients upon discharge, unless there are specific medical reasons not to do so. The goal is to lower the occurrence of negative heart-related events and reduce mortality rates.
- Documentation of PCI indication
PCIs are performed to improve symptoms or survival. Documentation of these elements helps determine patient’s indication for the procedure and also provides prognostic utility.
- No PCI- related complication
As complications have significant impact on patient survival and healthcare costs, it is important to monitor the complication rate to access outcomes and to identify possible areas for improvement.
- No cardiac specific readmission within 30 days post procedure
Such readmissions indicate potential adverse results associated with the procedure itself. Analyzing this data can assist in pinpointing areas for enhancement in order to optimize both medical treatment and post-discharge care.
- No in- hospital mortality
It is important to monitor in-hospital mortality rate to review practice patterns and to initiate improvements strategies.
- No 20 Group wide serious reportable events categories reported
To monitor, evaluate and review the various serious reportable events occurring in the hospitals and take corrective actions to address issues that have been identified. This is to prevent the recurrence of similar events, allowing cross learning and improvement.
Where does Pantai Hospital Kuala Lumpur stand
Against International Benchmark
Clinical Indicators | International Benchmark | 2022 | 2023 |
---|---|---|---|
Aspirin, Thienopyridines, Statins prescribed at discharge | 84.3% | 81% | 99% |
Documentation of PCI indication | 99.2% | 100% | 100% |
No PCI- related complication | 99% | 100% | 100% |
No cardiac specific readmission within 30 days post procedure | 93.5% | 99% | 100% |
No in- hospital mortality | 98.1% | 100% | 100% |
No 20 Group wide serious reportable events categories reported | 100% | 100% | 100% |
Reference:
Ahmad M, M. P. (2022, Jun 11). Percutaneous Coronary Intervention.