Evaluating the Feasibility of a Statewide Collaboration to Improve Cardiac Rehabilitation Participation THE MICHIGAN CARDIAC REHAB NETWORK
Evaluating the Feasibility of a Statewide Collaboration to Improve Cardiac Rehabilitation Participation THE MICHIGAN CARDIAC REHAB NETWORK
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DOI：
10.1097/hcr.0000000000000706
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发表时间：
2022-11-01
影响因子：
3.8
通讯作者：
Sukul, Devraj
中科院分区：
文献类型：
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作者：
Thompson, Michael P.;Yaser, Jessica M.;Sukul, Devraj
目的：区域质量改进协作可以提供一种解决方案，通过绩效基准和提供者参与来提高心脏康复（CR）的参与度。本研究的目的是评估密歇根心脏康复网络改善CR参与的可行性。研究方法：来自密歇根州价值协作的多付款人索赔数据被用来确定医院和CR设施，并组建一个多学科咨询小组。单变量分析描述了参与研究的医院特征和符合条件的条件下的医院级CR率，包括1年内入组、首次CR访视的平均天数和1年内CR访视的平均次数。选择了三个不同的公司责任设施进行虚拟现场访问，以确定成功的领域和改进的障碍。结果如下：共确定了95家医院和84家CR设施，其中48家医院（51%）提供介入心脏病学服务，33家医院（35%）提供心脏外科服务。组建了一个由17名成员组成的多学科咨询小组，代表13个机构和不同的角色。全州范围内符合条件的住院患者的CR入组率为33.4%，参与医院和符合条件的住院患者的CR性能指标差异很大。虚拟现场访问表明，个别公司在改善公司责任参与方面取得了成功，但参与方面存在着各种障碍，包括转介、能力和人员配备方面的限制以及地理和财政障碍。结论：这项研究证明了创建全州范围内的医院和CR设施合作的可行性，该合作的目标是公平地提高密歇根州所有合格患者的CR入组率，并得到多学科咨询小组和绩效基准的支持。
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.