An Example: Coronary Artery Bypass Graft Measures

1
An Example Coronary Artery Bypass Graft Measures

• Aspirin prescribed at discharge
• CABG using internal mammary artery1
• Prophylactic antibiotic received within one hour
  prior to surgical incision1,2
• Prophylactic antibiotic selection for surgical
  patients1,2
• Prophylactic antibiotics discontinued within 24
  hours after surgery end time1,2
• Inpatient mortality rate3
• Post operative hemorrhage or hematoma4
• Post operative physiologic and metabolic
  derangement4

1 National Quality Forum measure 2 CMS 7th Scope
of Work measure 3 Risk adjusted using 3M APR-DRG
methodology 4 AHRQ patient safety indicator
2
An Example CABG Patients with Hemorrhage/Hematoma
If all hospitals improve to top performance
levels, potentially preventable hemorrhages and
hematomas will decrease by 1.6. An estimated
360 patients per year will avoid this potentially
preventable post-operative complication, which
can add nearly 13,000 of additional cost and
extend length of stay by 4 days, if all hospitals
in the HQI project attain top performance levels.
40
30
20
10
Number of Facilities
0
6.4
6.3
6.1
6.0
5.9
5.8
5.6
5.5
5.4
5.3
5.1
5.0
4.9
4.8
4.6
4.5
4.4
Percent of CABG Patients with Hemorrhage/Hematoma
(a lower is better)
Source Premier, Inc. 2002 Perspective Online
dataset based on 550 hospitals
3
An Example Inpatient CABG Mortality Rate
30
If all hospitals improve to top performance
levels, mortality rates will drop by 1. An
estimated 220 lives per year will be saved, if
all hospitals in the HQI project attain top
performance levels.
20
10
Number of Facilities
0
.8
6.3
5.8
5.3
4.8
4.3
3.8
3.3
2.8
2.3
1.8
1.3
Percent of Inpatient CABG Mortality Rate (a
lower is better)
Source Premier, Inc. 2002 Perspective Online
dataset based on 550 hospitals