Keywords

cardiac event, cost analysis, patient safety, surgical care improvement project (SCIP), perioperative beta-blocker

 

Authors

  1. Sutherland, Tori MD, MPH
  2. Beloff, Jennifer RN, MSN, APN
  3. Lightowler, Marie MPH
  4. Liu, Xiaoxia MS
  5. Kachalia, Allen MD, JD
  6. Bates, David W. MD, MSc
  7. Urman, Richard D. MD, MBA

Abstract

The Surgical Care Improvement Project (SCIP) was launched in 2005. One of the SCIP metrics includes perioperative beta-blocker guideline (CARD-2), which measures the percentage of patients on a pre-operative beta-blocker with continued use in the perioperative period. Compliance is intended to decrease rates of acute myocardial infarction (AMI) and cardiac mortality among high-risk patients. We desired to create low cost, standardized processes on an institutional level to improve compliance with the SCIP CARD-2 metric. We assessed the impact of interventions on provider compliance with the SCIP CARD-2 metric and on simulated impact on institutional cost. We were able to improve CARD-2 compliance at one hospital within a year of intervention implementation. The hospital decreased its losses due to noncompliance in FY 2014 by $27 273. A relatively low cost intervention, aimed at educating providers that utilized existing infrastructure resulted in improved SCIP beta-blocker compliance. Changes in the reimbursement system made at the time of publication demonstrate that reimbursement measures are constantly in flux; tailored interventions based upon our successes may still produce similar results.