Evaluating the Feasibility of a Statewide Collaboration to Improve Cardiac Rehabilitation Participation
Evaluating the Feasibility of a Statewide Collaboration to Improve Cardiac Rehabilitation Participation
复制标题
评估全州范围内合作提高心脏康复参与度的可行性
DOI：
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发表时间：
2022
影响因子：
3.8
通讯作者：
Devraj Sukul
中科院分区：
文献类型：
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作者：
M. Thompson;J. Yaser;A. Forrest;S. Keteyian;Devraj Sukul
本研究证明了急症护理医院和心脏康复机构在全州范围内合作的可行性，该合作的中心目标是公平地提高密歇根州所有符合条件的患者的心脏康复登记，这是一个由多元化，多学科利益相关者团体支持并由绩效基准数据驱动的合作。目的：区域质量改进协作可以通过绩效基准和提供者参与提供一种改善心脏康复（CR）参与的解决方案。本研究的目的是评估密歇根心脏康复网络提高CR参与的可行性。方法：来自密歇根价值合作的多付款人索赔数据被用于确定医院和CR设施，并组建了一个多学科咨询小组。单变量分析描述了参与医院的特征和符合条件的医院级CR绩效率，包括1年内的入组情况、首次CR就诊的平均天数和1年内CR就诊的平均次数。选择了三种不同的CR设施进行虚拟现场访问，以确定成功的领域和改进的障碍。结果：共确定95家医院和84家CR机构，其中48家（51%）提供心脏介入服务，33家（35%）提供心脏外科服务。一个由17名成员组成的多学科咨询小组代表了13个机构和不同的角色。全州符合条件的住院患者的CR入学率为33.4%，参与医院和符合条件的住院患者的CR绩效指标差异很大。虚拟实地考察表明，个人在提高企业社会责任参与方面取得了成功，但参与过程中存在各种障碍，如转诊、能力和人员限制、地理和财务障碍等。结论：本研究表明，在多学科咨询小组和绩效基准的支持下，围绕公平提高密歇根州所有符合条件的患者CR登记的目标，在全州范围内建立医院和CR设施合作的可行性。
This study demonstrated the feasibility of a statewide collaboration of acute care hospitals and cardiac rehabilitation facilities centered around the goal of equitably improving cardiac rehabilitation enrollment for all eligible patients in Michigan, one that is supported by a diverse, multidisciplinary stakeholder group and is driven by performance-benchmarking data. Purpose: Regional quality improvement collaboratives may provide one solution to improving cardiac rehabilitation (CR) participation through performance benchmarking and provider engagement. The objective of this study was to evaluate the feasibility of the Michigan Cardiac Rehab Network to improve CR participation. Methods: Multipayer claims data from the Michigan Value Collaborative were used to identify hospitals and CR facilities and assemble a multidisciplinary advisory group. Univariate analyses described participating hospital characteristics and hospital-level rates of CR performance across eligible conditions including enrollment within 1 yr, mean days to first CR visit, and mean number of CR visits within 1 yr. Three diverse CR facilities were chosen for virtual site visits to identify areas of success and barriers to improvement. Results: A total of 95 hospitals and 84 CR facilities were identified, with 48 hospitals (51%) providing interventional cardiology services and 33 (35%) providing cardiac surgical services. A 17-member multidisciplinary advisory group was assembled representing 13 institutions and diverse roles. Statewide CR enrollment across eligible admissions was 33.4%, with wide variation in CR performance measures across participating hospitals and eligible admissions. Virtual site visits revealed individual successes in improving CR participation but a variety of barriers to participation related to referrals, capacity and staffing constraints, and geographic and financial barriers. Conclusions: This study demonstrated the feasibility of creating a statewide collaboration of hospitals and CR facilities centered around the goal of equitably improving CR enrollment for all eligible patients in Michigan that is supported by a multidisciplinary advisory group and performance benchmarking.
DOI：
10.1097/hcr.0000000000000447
发表时间：
2019-07
影响因子：
3.8
作者：
Thomas RJ;Beatty AL;Beckie TM;Brewer LC;Brown TM;Forman DE;Franklin BA;Keteyian SJ;Kitzman DW;Regensteiner JG;Sanderson BK;Whooley MA
通讯作者：
Whooley MA