Improving Cardiac Care – New Measure Helps Hospitals Focus on Readmissions After PCI
Percutaneous coronary intervention (PCI), also called angioplasty, is a common procedure to open narrowed or blocked arteries that supply blood to the heart. More than 600,000 PCIs are performed in the United States each year. These procedures are usually performed in the hospital and can be life-saving for heart attack patients. For other patients, PCI can reduce symptoms such as chest pain and improve quality of life. However, one in seven people who undergo PCI will end up back in the hospital, known as readmission, within 30 days of leaving the hospital after their procedure.
Why focus on readmissions?
Hospitals across the country are focused on reducing unplanned readmissions, or the number of patients who have to return to the hospital suddenly after being sent home. Being readmitted to the hospital may put patients at added risk for other health problems and can be stressful for patients and their families. Unplanned readmissions are also costly for the health care system. Readmission rates vary widely by hospital, suggesting that there may be room for improvement.
The American College of Cardiology (ACC), in partnership with Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (YNHHSC – CORE) and the Centers for Medicare & Medicaid Services (CMS), developed the PCI readmission measure to provide hospitals and the public with information about unplanned PCI readmission rates. This new tool shows how often Medicare patients are readmitted to hospitals within 30 days of discharge after a PCI procedure. Results are voluntarily reported by hospitals on Medicare’s Hospital Compare website.
How do I interpret my hospital’s results?
You can see your hospital’s results by visiting the PCI Readmission page on Hospital Compare. Here you can search by hospital name and state.
Sample PCI Readmission data:
The results show whether a hospital’s 30-day PCI readmission rate is better than, worse than, or no different than other hospitals in the ACC’s NCDR CathPCI Registry®. The measure takes into account how sick patients were before they were admitted to the hospital for their PCI procedure and differences in readmission rates that might be due to chance. For example, patients who are older and have other medical problems are more likely to be readmitted than younger, healthier patients. The measure accounts for these differences through risk adjustment and produces a risk-standardized PCI readmission rate for each hospital.
For more information about how the PCI readmission measure calculates hospital performance, please click here.
How can I use this information?
If you or someone you know is having a planned PCI procedure, this measure allows you to determine how well different hospitals in your area perform with respect to readmissions, if the hospitals voluntarily participated in the CathPCI Registry®. Please note that the measure is intended to identify hospitals with higher than expected unplanned readmissions after a PCI procedure. It is not intended to dictate your plan of care, which should be determined by you and your doctor.
What if my hospital’s results aren’t listed?
There are several reasons you may not find your hospital’s results on Hospital Compare:
- They may have elected not to share the information publicly.
- They may not participate in the CathPCI Registry®.
- They may not perform PCI procedures.
What Can Hospitals Do to Lower PCI Readmissions?
Hospitals can do several things to help prevent patients from being readmitted after a PCI procedure.
- Give patients clear discharge instructions, including symptoms they should monitor closely, and when to seek follow-up care
- Ensure clear communication between the patient and their medical team across care settings
- Educate the patient about how to prevent problems and manage his/her condition
- Coordinate prescriptions so that new medications do not interfere with other medications or supplements patients may be taking
- Teach patients about potential side-effects of medications and what to do if they occur
What Can You Do to Prevent Readmission After PCI?
Patients can do several things to help lower the chances that they will need to return to the hospital after a PCI procedure.
Here are some tips:
- Understand why PCI was needed and what it means. Knowing what is going on in your body will help you take action to stay healthy.
- Follow all discharge instructions. Make sure you understand how to care for yourself at home. For example, which medications you need to take and when, any warning signs of problems, and/or if there are certain activities you should avoid and for how long.
- Take your medications as directed. Your heart doctor (cardiologist) may prescribe blood thinners and other medications to manage your condition. Don’t stop taking these without talking to your doctor first. To learn more about common heart medicines go to CardioSmart's Find a Drug page.
- Schedule (and keep) follow-up appointments with your cardiologist. This will help you work together to track your progress and know if treatments are working.
- Ask about cardiac rehabilitation. These programs are tailored to individual patients and can help lower the risk of future heart problems, and may involve a team of health professionals providing education and support to help you recover and start new, healthy habits, such as eating right and getting more exercise.
- Commit to a heart-healthier life. To keep your heart healthy and your arteries open, you need to live a healthier life. For example, eat a heart-healthy, low sodium diet, exercise, stop smoking (if you smoke), and learn to reduce stress.
- Report any changes. Tell your doctor if you start having chest pains or any other new or changing symptoms.
More About the PCI Readmission Voluntary Public Reporting Effort
Since 1998, the ACC has collected data from hospitals about patients who undergo PCI during their hospitalization. This information is recorded in the CathPCI Registry® as part of the National Cardiovascular Data Registry. This collaboration with Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation and CMS, provides hospitals with a report that allows them to see information about their readmissions, including the primary reason their patients were readmitted to the hospital and to which hospitals their patients were readmitted. This information allows hospitals to develop and focus strategies to reduce readmissions tailored to their patient population. The PCI readmission measure is part of a pilot initiative to publicly report voluntary measure results. The ACC plans to launch additional public reporting efforts in the future.
This effort is part of the ACC’s ongoing mission to transform cardiovascular care and improve heart health. Stay tuned for more information as this pilot takes off.