Key result
A statewide quality improvement initiative is linked to ~98% greater annual intracoronary imaging for PCI.
Why the study?
This study assessed the temporal trend in intracoronary imaging-guided PCI concurrent with the implementation of a statewide quality improvement initiative to increase intracoronary imaging use.
Does a statewide quality improvement initiative increase the use of intracoronary imaging for PCI optimization?
Observational
Yes
Does a statewide quality improvement initiative increase the use of intracoronary imaging for PCI optimization?
A statewide quality improvement initiative involving education, comparative reporting, and performance tracking was associated with a nearly twofold yearly increase in the odds of using intracoronary imaging during PCI.
Supports statewide QI to raise intracoronary imaging rates in PCI; extends implementation evidence but leaves outcome impact unresolved.
Background: This study assessed the temporal trend in intracoronary imaging (ICI)-guided percutaneous coronary intervention (PCI) concurrent with the implementation of a statewide quality improvement initiative to increase ICI use. Methods: The Blue Cross Blue Shield of Michigan Cardiovascular Consortium implemented a formal initiative to increase ICI use for PCI optimization in the state of Michigan between 2020 and 2023. The initiative included focused education for physicians, reporting of comparative institution-level ICI use, and tracking of ICI use as a performance metric. The primary measure of interest was the use of ICI to optimize PCI. A hierarchical Bayesian regression model was created to assess the increase in ICI use over time. The year in which a PCI was performed was included as a variable in the model to delineate the impact of time on the odds of ICI use. Each 1-year increase in time was associated with a significant increase in ICI use (adjusted odds ratio, 1.98; 95% credible interval, 1.95-2.00). Conclusions: Concurrent with a statewide quality improvement initiative, a significant increase in ICI use to optimize PCI was observed among patients undergoing PCI in the state of Michigan.
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Madder et al. (2025) conducted an observational in Percutaneous coronary intervention. Statewide quality improvement initiative vs. Prior time periods (temporal trend) was evaluated on Use of intracoronary imaging to optimize PCI (adjusted OR 1.98, 95% CI 1.95-2.00, p=<.001). A statewide quality improvement initiative was associated with a significant temporal increase in intracoronary imaging use for PCI optimization (adjusted OR 1.98 per year; 95% CrI 1.95-2.00; P<.001).
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