Remote clinical quality management of endovascular care
А. Yu. Abramov,
D. I. Kicha,
R. S. Goloshchapov-Aksenov,
O. V. Rukodayniy,
А. М. Nazarov,
А. G. Koledinsky https://doi.org/10.17802/2306-1278-2021-10-4-106-111
Аннотация
Aim. To assess the effectiveness of remote clinical quality management of endovascular care.
Methods. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005.
Results. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In AprilDecember 2020 it increased up to 71.6% (p<0.001). The frequency of performing PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005).
Conclusion. Remote clinical management based on telemedicine and mentoring process technologies contributes to improving the quality of endovascular care in MI.
Об авторах
А. Yu. Abramov
Рeoples Friendship University of Russia (RUDN University)
Россия
Россия
Abramov Aleksey Yu., DMSi, Director of the Medical Institute
6, Miklukho-Maklaya St., Moscow, 117198
D. I. Kicha
Рeoples Friendship University of Russia (RUDN University)
Россия
Россия
Kicha Dmitry I., DMSi, Professor of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene of the Faculty of Continuing Medical Education of the Medical Institute
6, Miklukho-Maklaya St., Moscow, 117198
R. S. Goloshchapov-Aksenov
Рeoples Friendship University of Russia (RUDN University)
Россия
Россия
Goloshchapov-Aksenov Roman S., DMSi, Associate Professor at the Department of Cardiology, X-ray Endovascular and Hybrid Methods of Diagnosis and Treatment of the Faculty of Continuing Medical Education of the Medical Institute
6, Miklukho-Maklaya St., Moscow, 117198
O. V. Rukodayniy
Рeoples Friendship University of Russia (RUDN University)
Россия
Россия
Rukodayny Oleg V., DMSi, MBA, Acting Head of the Department of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene of the Faculty of Continuing Medical Education of the Medical Institute
6, Miklukho-Maklaya St., Moscow, 117198
А. М. Nazarov
Orenburg State Medical University
Россия
Россия
Nazarov Alexandr M., DMSi, Associate Professor, lecturer at the Department of Anesthesiology and Resuscitation of the Pediatric Faculty, Orenburg State Medical University
6, Sovetskaya St., Orenburg, 460000
А. G. Koledinsky
Рeoples Friendship University of Russia (RUDN University)
Россия
Россия
Koledinsky Anton G., Head of the Department of Cardiology, Endovascular and Hybrid Treatment of the Medical Institute
6, Miklukho-Maklaya St., Moscow, 117198
Список литературы
1. Khan M.A., Hashim M.J., Mustafa H., Baniyas M.Y., Suwaidi S.K.B.M., AlKatheeri R., Alblooshi F.M.K., Almatrooshi M.E.A.H., Alzaabi M.E.H., Darmaki R.S., Lootah S.N.A.H. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 2020;12(7):e9349. doi: 10.7759/cureus.9349.
2. Maingard J., Kok H.K., Ranatunga D., Brooks D.M., Chandra R.V., Lee M.J., Asadi H. The future of interventional and neurointerventional radiology: learning lessons from the past. Br J Radiol. 2017;90(1080):20170473. doi: 10.1259/bjr.20170473.
3. Gillis N., Arslanian-Engoren C., Struble L. Acute Coronary Syndromes in Older Adults: A Review of Literature. Journal of Emergency Nursing. 2013; 40(3): pp. 270–275. doi: 10.1016/j.jen.2013.03.003.
4. EpiCast Report: Acute Coronary Syndrome ACS - Epidemiology Forecast to 2025. Cardiovascular Week. 2014; p. 17. http://www.reportlinker.com/p01957646/EpiCast-Report-Acute-Coronary-Syndrome-ACS---Epidemiology-Forecastto-2022.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=Pathology
5. De Filippo O., D’Ascenzo F., Angelini F., Bocchino P.P., Conrotto F., Saglietto A., Secco G.G., Campo G., et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. New Engl. J. Med. 2020; 383: pp. 88-89. doi: 10.1056/NEJMc2009166.
6. Garcia S., Albaghdadi M., Meraj P., Schmidt C., Garberich R., Jaffer F.A., Dixon S., Rade J.J., Tannenbaum M., Chambers J., Huang P.P., Henry T.D. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J. Am. Coll. Cardiol. 2020; 75(22): pp. 2871-2872. doi: 10.1016/j.jacc.2020.04.011.
7. Hall M., Bebb O., Dondo T., Yan A.T., Goodman S.G., Bueno H., Chew D.P., Brieger D., Batin P.D., Farkouh M.E., Hemingway H., Timmis A., Fox K.A.A., Gale C.P. Guidelineindicated treatments and diagnostics, GRACE risk score, and survival for non-ST elevation myocardial infarction. Eur Heart J. 2018;39(42):3798-3806. doi: 10.1093/eurheartj/ehy517.
8. Odiorne G. Mentoring - an American management innovation. Personnel Administrator. 1985; 30:63-65.
9. Alred G., Garvey B., Smith R. The Mentoring pocketbook. United Kingdom: British Llibrary. Management pocketbook; 2010.128 p.
10. Demaerschalk B.M., Berg J., Chong B.W., Gross H., Nystrom K., Adeoye O., Schwamm L., Wechsler L., Whitchurch S. American Telemedicine Association: Telestroke Guidelines. Telemed J E Health. 2017;23(5):376-389. doi: 10.1089/tmj.2017.0006.
11. Голощапов-Аксенов Р.С., Семенов В.Ю., Кича Д.И. Организационные и клинические основы рентгенохирургических методов диагностики и лечения сердечно-сосудистых заболеваний. М.: МИА; 2019. 365 c.
12. Goloshchapov-Aksenov R.S., Kicha D.I. The organizational and legal framework and history of X-ray endovascular care in the Russian Federation. Вопросы истории. 2020; 6: 179-184. doi: 10.31166/VoprosyIstorii202006Statyi13
Рецензия
Для цитирования:
Abramov А.Y., Kicha D.I., Goloshchapov-Aksenov R.S., Rukodayniy O.V., Nazarov А.М., Koledinsky А.G. Remote clinical quality management of endovascular care. Комплексные проблемы сердечно-сосудистых заболеваний. 2021;10(4):106-111. https://doi.org/10.17802/2306-1278-2021-10-4-106-111
For citation:
Abramov A.Yu., Kicha D.I., Goloshchapov-Aksenov R.S., Rukodayniy O.V., Nazarov A.M., Koledinsky A.G. Remote clinical quality management of endovascular care. Complex Issues of Cardiovascular Diseases. 2021;10(4):106-111. https://doi.org/10.17802/2306-1278-2021-10-4-106-111
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