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In this volume we highlight the following (click on a link to view an article):
 

Announcing First Annual VQI Meeting – VQI@VAM - Save the Date

The Vascular Quality Initiative (VQI) is pleased to announce its first annual VQI meeting on Wednesday, June 8, 2016, one day prior to the official start of the 2016 Vascular Annual Meeting, at the same venue. The Meeting will offer a full day of educational content geared toward helping attendees gain a better understanding of the VQI Registries and building quality improvement skills to leverage the maximum potential of the VQI data.
 
The morning sessions of VQI@VAM will focus on topics of particular interest to data managers. The afternoon sessions will highlight content of interest to physicians, data managers and QI personnel.  Case studies of successful VQI quality improvement projects will be presented by VQI centers, along with practical training on the quality improvement techniques used. Click here for more information on the event and registration.
 

Meaningful Use

There has been much discussion about Meaningful Use recently, especially as the February 29 deadline of Registration of Intent approaches. The Vascular Quality Initiative®, when combined with Data Import, qualifies as a specialized registry. We are prepared to help you meet the necessary requirements of Specialized Registry Reporting (objective 10, measure 3). 

MORE ABOUT MEANINGFUL USE
DOWNLOAD THE MEANINGFUL USE REGISTRATION OF INTENT
 

2015 VQI Participation Awards


VQI centers have just received letters announcing the results of the 2015 VQI Participation Awards, and we want to congratulate all of the centers that received awards.

The Awards are based on center participation in three categories: long-term follow-up reporting, number of registries subscribed and regional meeting physician attendance. 308 centers were eligible for the Participation Awards (centers must have joined VQI before 2015 to be eligible to participate this year).  We will recognize the individual centers that received VQI Participation Awards in the next issue of the VQI Pulse. The percentage of centers awarded Stars for their participation were: 
  • 11% of VQI centers -        3 Stars
  • 24% of VQI centers -        2 Stars
  • 27% of VQI centers –       1 Star
  • 38% of VQI centers –       0 Stars
 
Example – Participation Award and Letter


Toolkit to Improve Long-Term Follow-Up (LTFU)

LTFU reporting is a key component to meaningful participation in the VQI and is one of the three primary components of the VQI Participation Awards program. The SVS PSO has developed a LTFU Toolkit to assist members with suggestions and templates, based on the best practices of centers with the highest rates of long-term follow-up.  Click the link below to learn more.

LTFU Suggestions for Success
 

QI Stories, Tools, and Reports

In addition to the VQI Annual Meeting, we are expanding the knowledge base of QI activities, publications and programs within the VQI and from the broader QI community.  We have begun to formally identify and categorize the lessons learned from QI projects at VQI centers, as well as highlight noteworthy QI initiatives outside of the VQI.  This section highlights a VQI education flyer on the importance of discharge medications to improve long term survival, followed by two external QI publications – a short video on getting started in QI and a national report on total systems safety.   
 
New DC Medication Flyer
Randall De Martino, MD (Upper Midwest Vascular Network) designed a flyer for patients and providers that shows the value of post-op surgery medications and the impact on survival for patients who received statins and anti-platelet agents at discharge following arterial procedures. They found that VQI participation improved the use of medical management and that involvement in an organized quality effort can affect patient outcomes. Click here to view the DC Medication Flyer for use in your facility.
 
“Illustrated Look at Quality Improvement in Healthcare”
Dr. Michael Evans, Associate Professor of Family Medicine at the University of Toronto, produced this short video for the Institute for Healthcare Improvement called an Illustrated Look at Quality Improvement in Healthcare.  Less than 9 minutes long, it provides an approach to getting started with quality improvement projects, touches on system design and issues the familiar challenge, "What can you do by next Tuesday?"
 
http://www.ihi.org/resources/pages/audioandvideo/mikeevansvideoqihealthcare.aspx
 
Expert Panel Recommends Accelerated Efforts for Total Systems Safety
 
The National Patient Safety Foundation convened an expert panel for the report, Free from Harm, Accelerating Patient Safety Improvement Fifteen Years After To Err is Human in 2015. The report, led by Donald Berwick, MD, MPP, is a call for accelerating improvements in care, requiring a shift from reactive, piecemeal interventions to a total systems approach to safety and improvement.  According to the President and CEO of NPSF, Tejal Gandhi, MD, MPH, “1 in 10 patients still experiences a hospital-acquired complication, and many more harms occur in outpatient settings, where most care is provided, so there is still much work to be done.” The report provides a detailed set of tactics and makes eight key recommendations to achieve total systems safety:
 
1.      Ensure that leaders establish and sustain a safety culture
2.      Create centralized and coordinated oversight of patient safety
3.      Create a common set of safety metrics that reflect meaningful outcomes
4.      Increase funding for research in patient safety and implementation science
5.      Address safety across the entire care continuum
6.      Support the health care workforce
7.      Partner with patients and families for the safest care
8.      Ensure that technology is safe and optimized to improve patient safety
 
http://www.npsf.org/?page=freefromharm
 

Regulatory Issues and Updates

SVS Offers Guidance on PQRS and Impact on Reimbursement

Physicians who participate in a qualified Physician Quality Reporting System (PQRS) registry can earn a performance based incentive plus avoid an automatic downward payment adjustment under Medicare’s Value Modifier Program. The Value Modifier program provides for differential reimbursements to physicians based upon their performance on quality-of-care measures. The VQI Registry is a qualified PQRS registry; physicians who participate in the VQI can use the registry to meet the Medicare reporting requirements.

Medicare is aligning the Value Modifier Program’s quality measurement component with the reporting requirements under the PQRS, so all physicians seeking payment for professional services under Medicare must be enrolled in a qualified PQRS program. Beginning January 1, 2017, the Value Modifier will be applied to physician payments under the Medicare PFS for physician solo practitioners and physicians in groups with two or more eligible professionals. The SVS Quality and Performance Measurement Committee will be publishing additional information on this topic next month. 
 

VQI Quality Research Corner

“Contrast-Induced Nephropathy (CIN): Comparative Effectiveness of Preventive Measures”

This AHRQ-sponsored report was prepared by the Johns Hopkins University Evidence-based Practice Center and issued January 2016.  The center conducted a systematic review of the effectiveness of different measures for preventing CIN in patients undergoing imaging studies requiring intravenous or intra-arterial contrast media. Several VQI Regional Quality Groups have examined this problem, including the Rocky Mountain VQI, the Michigan VSG and the VSGNE, because of increasing rates of CIN identified in the VQI database and the lack of clear consensus about the most effective intervention to prevent or reduce CIN. 
 
The AHRQ report addressed the question: What is the comparative effectiveness of interventions to prevent contrast-induced nephropathy chronic kidney disease, end-stage renal disease, mortality, and other adverse events? The authors concluded that of all the interventions that have been used to reduce the risk of CIN, only three have evidence to support a clinically important benefit, and the low-strength evidence of their benefit is limited to specific contexts.
 
Key Research Findings:
  • Statins with intravenous saline reduce the risk of CIN, whether compared with intravenous saline alone or with N-acetylcysteine, but the evidence is limited to patients receiving intra-arterial contrast media.
  • N-acetylcysteine with intravenous saline, compared with intravenous saline alone, appears to have a small benefit in reducing the risk of CIN, but only in patients receiving LOCM.
  • Similarly, in patients receiving LOCM, sodium bicarbonate appears to have a small benefit in reducing the risk of CIN when compared with intravenous saline.
 
https://www.effectivehealthcare.ahrq.gov/ehc/products/530/2167/nephropathy-contrast-induced-prevention-report-150107.pdf
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VQI Reports and News Briefs


Daniel Bertges, MD, (VSGNE) and the PVI Registry Committee have done extensive work to evaluate and revise the current PVI Registry.  Input from VQI members attending the VEITH meeting, as well as FDA and industry, was obtained.  The goal is to collect more detailed data about specific devices used in PVI treatment, including newer drug coated balloons and stents, since these details likely affect outcome.  The committee has worked to achieve a balance between collecting all the data required to support quality improvement efforts and minimizing the data entry burden on each site. M2S is developing the data specifications and expects to complete the changes to the module by mid-2016. 
  
 Physician Level Reports Planned for 2016
  • PVI Ultrasound Guidance/Complication Rates
  • One Year Survival After Elective TEVAR
  • One Year Survival After Elective EVAR
Center Opportunity Profile for Improvement (COPI) Reports Planned for 2016
  • CEA stroke/death
  • CAS stroke/death
 
17 Regional Reports have been issued in late February to coincide with the launch of the 2016 Spring Regional Meetings.  The reports include regional level data on mortality, LOS and complication rates for high volume and high risk vascular procedures.
 

M2S PATHWAYS Technology Update


M2S has completed several updates to the PATHWAYS platform used in VQI:
 
Text-based data download now available for TEVAR, EVAR, Varicose Vein and Hemodialysis Access. This functionality allows users to download VQI data in text instead of numeric format so that they don’t need to decode the data using the data dictionary.
 
Standard Data Import from hospital EMRs now accepts ICD-10 codes in addition to ICD-9 and CPT codes.
 
The TEVAR Registry now includes a new “Iliac Devices” tab to capture up to four iliac devices, and has been expanded to include more iliac and branch devices.
 

List of Current VQI Quality Research Projects Click here for the current research projects

 

Latest VQI Participation and Volume Statistics

Click here for the current volumes for specific VQI Registries.
Click here for the list of VQI Participating Facilities.
 
Number of procedures in all VQI Registries 271,819
Total VQI Centers 376
Number of procedures added (Jan) 8,123
Total Regional Quality Groups 17
New Members (as of January) Anderson Regional Medical Center (SEVSG)
Barnabas Health (3 sites listed - MAVSG)
Beacon Health Clinic (MVC)
Centra Health (Virginias)
Columbia St Mary's (UMVC)
Columbia University (VSGGNY)
Medical Center Hospital  (SoVONet)
Memorial Hospital West (SEVSG)
Memorial Hospital  Pembroke (SEVSG)
North Florida Regional Medical Center (SEVSG)
Rex Healthcare (Carolinas)
Vascular Surgery Associates (SEVSG)
Washington Hospital (NCVSG)
 
 
If you’d like to know more about any of our recent activities, or have suggestions on other topics, please email communications@svsvqi.org