Cardiac Quality Improvement Initiative

The New York State Department of Health Cardiac Services Program

This program has helped to establish New York State as a nationwide leader in outcomes assessment and public reporting and has successfully integrated rigorous data validation and analyses into broader quality improvement activities.

Program goals include:

  • Improving the results of different treatments of heart disease;
  • Providing hospitals and physicians with information that can be used to improve processes and outcomes for these treatments;
  • Providing information to help patients make better decisions about their own care;
  • Identifying and addressing barriers to equitable access to appropriate cardiac care.

 

Cardiac Surgery Reporting System (CSRS) and Percutaneous Coronary Interventions Reporting System (PCIRS)

The New York State Department of Health Cardiac Surgery Reporting System (CSRS) was instituted in 1989 with the guidance of the NYS Cardiac Advisory Committee. The partner PCI Reporting System was added in 1991. The results have been used to create a cardiac profile system which assesses the performance of hospitals and surgeons over time, independent of the severity of individual patient’s pre-operative conditions. Detailed statistical analyses of the information received from the study have been conducted under the guidance of the New York State Cardiac Advisory Committee (CAC), a group of independent practicing cardiac surgeons, cardiologists and other professionals in related fields. These registries and the public release of hospital reports were among the first of their kind and continue to provide a model for other states developing public reporting.

Reports detailing hospital and physician specific outcomes for Coronary Artery Bypass Surgery, Valve Surgery and Percutaneous Coronary Interventions are released annually by the Department of Health. (Link to reports). Outcomes for Pediatric Congenital Cardiac Surgery are also released.

The experience of this program has been that providing hospitals, cardiac surgeons and cardiologists with data about their own outcomes for these procedures allows them to examine the quality of their own care, and to identify opportunities to improve that care.

Data collected in CSRS and PCIRS have also contributed to improved patient care throughout and beyond New York State by contributing substantially to the literature on outcomes for cardiac procedures. These studies, published in numerous peer-reviewed journals, include evaluation of the impact of patient characteristics, treatment strategy and provider characteristics on short and longer-term outcomes.

The Department of Health CSRS and PCIRS data are also used by the Department for monitoring, planning and regulatory functions.

 

Access to Care

The Cardiac Diagnostic Catheterization Database ( (CD)2 ) is a NYS Department of Health study which began collecting data for patients undergoing diagnostic catheterization in 2003. Currently, eighteen hospitals around New York State participate in this project.

This study will provide ability to:

  • Identify and study barriers to care
  • Evaluate strategies for overcoming barriers to appropriate care
  • Track post catheterization referrals
  • Enhance appropriate referrals
  • Provide a basis for refining referral guidelines

 

Other Cardiac Services Program Initiatives

The Department of Health Cardiac Services Program has also been active in developing mechanisms to evaluate and improve the treatment of Acute Myocardial Infarction. Additionally, activities aimed at supporting and enhancing hospital-based Quality Improvement activities have been undertaken.