Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Sep 2014
Multicenter StudyReducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention.
Contrast-induced acute kidney injury (CI-AKI) is associated with increased morbidity and mortality after percutaneous coronary interventions and is a patient safety objective of the National Quality Forum. However, no formal quality improvement program to prevent CI-AKI has been conducted. Therefore, we sought to determine whether a 6-year regional multicenter quality improvement intervention could reduce CI-AKI after percutaneous coronary interventions. ⋯ Simple cost-effective quality improvement interventions can prevent ≤1 in 5 CI-AKI events in patients with undergoing nonemergent percutaneous coronary interventions.
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Circ Cardiovasc Qual · Sep 2014
Multicenter Study Comparative StudyAccess to coronary artery bypass graft surgery under pay for performance: evidence from the premier hospital quality incentive demonstration.
Although pay for performance (P4P) has become common, many worry that P4P will lead providers to avoid offering surgical procedures to the sickest patients out of concern that poor outcomes will lead to financial penalties. ⋯ Our results show no evidence of a deleterious effect of P4P on access to coronary artery bypass graft surgery for high-risk patients with AMI. These results should be reassuring to those concerned about the potential negative effect of P4P on high-risk patients.