Primary PCI Monitoring Performance

1
Primary PCI Monitoring Performance
Produced by Paul Arnold Clinical Quality
Department
Date 09th November 2012
2
Overview of the Performance Data
Service Total Overview

• Primary PCI Pathway Activations (1st
  October 11 31st October 12)

PPCI Pathway Activations (1404)
n4
Incorrect use of Pathway x4
NON- PPCI (458)
PCI attempted (946)
n44
TBC n2
N452
Correct use NO PPCI x44
n408
n139
All genuine activations
Incorrect activations x139
n269
n4
To unwell to perform x2 procedure Patient
refuse consent x1 Other x1
All suspected MI cases Managed as PPCI
n266
n172
Angiography performed
Not an MI NO PCI x172
3
Overview of the Performance Data
Service Total Overview

• Primary PCI Pathway Activations (1st
  October 11 31st October 12)

PPCI Pathway Activations (1404)
n94
n94
PCI not indicated x40 Occlusion small
vessel Surgical disease x36 To unwell
to perform PCI x9 Occlusion small vessel PCI
indicated but x7 Not possible/
attempted Early Deaths x2
Potential culprit lesion confirmed
N946
PCI procedure attempted
TBC (5)
PCI failed (22)
PCI partial success (27)
TIMI 3 (892, 94.7)
4
Contents

• Data Review 01.10.11 31.10.12
• 1404 Primary PCI pathway activations identified.
  Of which, 67.3 (946/ 1404) had a PPCI.
• - 43 Inpatients excluded in CTB figures
  only
• - 903 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
• Mortality rate
• Discussion
• Thanks

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 Oct
2012
7
Key Summary Statistics
Primary PCI Call-to-Balloon
Call or Self-Present
Balloon
8
Key Summary Statistics
Primary PCI CTB Time Performance (Oct 2011
Oct 2012)
n903
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 (Oct 2011
Oct 2012)
n903
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 (80.6 compliant
lastlt 12mths)
Median 103mins (Last lt12mths)
13
Key Summary Statistics
Overall Direct Success CTB (Target 120mins)
Median 89mins (Last lt12mths)
National target 150minutes CTB (98.6 compliant
lastlt 12mths)
14
Key Summary Statistics
Overall Inter-Hospital Transfer Success CTB
(Target 120mins)
Median 140mins (Last lt12months)
National target 150minutes CTB (58 compliant
lastlt 12mths)
15
Key Summary Statistics
Median Interval times for gt Inter-Hospital
Transfers (Oct 2011 Oct 2012)
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)
N946
18
Key Summary Statistics
Overall Success of PPCI
19
Key Summary Statistics
Overall Summary Statistics by Consultant
  No. of cases Complete Success Mortality Mortality
Andron 103 97 3 2.9
Appleby 97 99 3 3.0
Khand 102 89 3 2.9
Mills 290 93 12 4.1
Morris 286 94 11 3.8
Morrison 299 94 11 3.6
Munir 54 96 1 1.8
Palmer 353 95 13 3.6
Perry 297 93 12 4.0
Stables 302 92 10 3.3
Ramsdale 197 93 5 2.5
Velavan 185 97 4 2.1
Fisher 6 83 - -
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 (Aug 2011 Aug 2012)
N946
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 (Oct 2011
Oct 2012)
N946
27
Any Questions