Primary PCI Monitoring Performance

1
Primary PCI Monitoring Performance
Produced by Paul Arnold Clinical Quality
Department
Date February 2013
2
Overview of the Performance Data
Service Total Overview

• Primary PCI Pathway Activations (1st Jan
  12 31st Jan 13)

PPCI Pathway Activations (1466)
n3
Incorrect use of Pathway x3
NON- PPCI (502)
PCI attempted (964)
n49
TBC n5
N494
Correct use NO PPCI x49
n445
n169
All genuine activations
Incorrect activations x169
n276
n8
To unwell to perform x1 procedure Patient
refuse consent x1 Other x6
All suspected MI cases Managed as PPCI
n268
n159
Angiography performed
Not an MI NO PCI x159
3
Overview of the Performance Data
Service Total Overview

• Primary PCI Pathway Activations (1st Jan
  12 31st Jan 13)

PPCI Pathway Activations (1466)
n109
n109
PCI not indicated x43 Occlusion small
vessel Surgical disease x39 To unwell
to perform PCI x16 Occlusion small vessel PCI
indicated but x9 Not possible/
attempted Early Deaths x2
Potential culprit lesion confirmed
N964
PCI procedure attempted
TBC (7)
PCI failed (23)
PCI partial success (33)
TIMI 3 (901, 93.4)
4
Contents

• Data Review 01.01.12 31.01.13
• 1466 Primary PCI pathway activations identified.
  Of which, 66 (964/ 1466) had a PPCI.
• - 44 Inpatients excluded in CTB figures
  only
• - 920 were analysed in CTB data
• Overview of the Performance Data
• Service Total Overview
• Admission Source
• PPCI activations
• CTB analysis
• DTB analysis
• PPCI Success Rate
• Summary Statistics by Consultant
• Length of Stay CCU Inpatient stay
• Mortality rate
• 30-day Mortality
• 30-day Readmissions

5
Key Summary Statistics
Overall Admission Source
NB Inter-hospital INP were excluded as part of
MINAP CTB criteria
6
Key Summary Statistics
Primary PCI Pathway Activations Jan 2011 gt Dec
2012
7
Key Summary Statistics
Primary PCI Call-to-Balloon
Call or Self-Present
Balloon
8
Key Summary Statistics
Primary PCI CTB Time Performance (Jan 2012
Jan 2013)
n920
Median 103mins (Last lt12months)
9
Key Summary Statistics
Primary PCI Overall CTB 120 Yearly Performance
Median 103mins (Last lt12mths)
10
Key Summary Statistics
Primary PCI CTB Time Performance (Jan 2012
Jan 2013)
n920
Median 103mins (Last lt12months)
11
Key Summary Statistics
Primary PCI Overall CTB 150 Yearly Performance
Median 103mins (Last lt12months)
12
Key Summary Statistics
Overall Success CTB (Target 120mins)
National target 150minutes CTB (LHCH 84 vs
National 12-13 82)
Median 103mins (Last lt12mths)
13
Key Summary Statistics
Overall Direct Success CTB (Target 120mins)
Median 89mins (Last lt12mths)
National target 150minutes CTB (LHCH 98.6 vs
National 12-13 87)
14
Key Summary Statistics
Overall Inter-Hospital Transfer Success CTB
(Target 120mins)
Median 139mins (Last lt12months)
National target 150minutes CTB (LHCH 57 vs
National 12-13 51)
15
Key Summary Statistics
Median Interval times for gt Inter-Hospital
Transfers (Jan 2012 Jan 2013)
NB Self presenters Inpatients are excluded
from this slide
16
Key Summary Statistics
LHCH -gt Balloon
LHCH Door
Balloon
17
Key Summary Statistics
Overall patients treated within DTB Target 90mins
Median 34mins (Last lt12months gt National 42mins
18
Key Summary Statistics
Overall Success of PPCI
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Key Summary Statistics
Overall Summary Statistics by Consultant
  No. of cases Complete Success Mortality Mortality
Andron 121 96 3 2.4
Appleby 115 97 4 3.4
Khand 115 89 4 3.4
Mills 313 92 13 4.1
Morris 308 94 11 3.5
Morrison 328 95 11 3.3
Munir 76 94 3 3.9
Palmer 366 95 14 3.8
Perry 313 92 12 3.8
Stables 319 94 10 3.1
Ramsdale 196 93 5 2.5
Velavan 198 96 4 2.0
Fisher 8 75 - -
20
Key Summary Statistics
Length of Stay on CCU Target 12 hours
21
Key Summary Statistics
Overall Average Length of Stay on CCU
22
Key Summary Statistics
Total Length of Stay in Hospital 72 hour target
23
Key Summary Statistics
Total Length of Stay (Jan 2012 Jan 2013)
24
Key Summary Statistics
Overall In-Hospital Mortality in STEMI Inpatients
admitted for PPCI
25
Key Summary Statistics
Overall In-Hospital Mortality in Patients that
underwent a PPCI
26
Key Summary Statistics
Primary PCI In-Hospital Mortality (Jan 2012
Jan 2013)
N964
27
Key Summary Statistics
Primary PCI Activation 30-day Mortality
28
Key Summary Statistics
Primary PCI Performed 30-day Mortality
30DM in STEMI patients (National gt8 11-12)
29
Key Summary Statistics
Primary PCI activation 30-day Re-admissions
30
Key Summary Statistics
Primary PCI Performed 30-day Readmissions
31
Any Questions