Open AccessRemote clinical quality management of endovascular care
Author(s) -
A.I. Abramov,
Д И Кича,
Р. С. Голощапов-аксенов,
O. V. Rukodayniy,
А. М. Назаров,
A. G. Koledinsky
Publication year - 2021
Publication title -
kompleksnye problemy serdečno-sosudistyh zabolevanij
Language(s) - English
Resource type - Journals
eISSN - 2587-9537
pISSN - 2306-1278
DOI - 10.17802/2306-1278-2021-10-4-106-111
Subject(s) - medicine , conventional pci , quality management , psychological intervention , medical emergency , health care , percutaneous coronary intervention , emergency medicine , myocardial infarction , management system , operations management , nursing , economics , economic growth
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.