NICOR, the Society for Cardiothoracic Surgery (SCTS), and the University of Manchester, has released the SCTS Governance Tool. This new online rescource enables cardiac surgery consultants to access information about their clinical activity and outcomes, which facilitates effective monitoring of data quality and clinical practice. The tool allows selection of time periods and operative groups to generate downloadable reports ‘on demand’, which show analysis based on up-to-date, and 'cleaned', National Adult Cardiac Surgery Audit (NACSA) data. More...
Published: Feb 7, 2014 3:28:12 PM
The 2012 annual report on devices from the Cardiac Rhythm Management National Audit has now been published. It is available to view and download from: More...
Published: Feb 5, 2014 1:48:26 PM
NICOR (The National Institute for Cardiovascular Outcomes Research) collects patient information from hospitals across the UK to try and improve the quality of care and outcomes for patients that have heart problems and treatments. These include adult heart surgery, heart attack, heart procedures, heart devices (for example pacemakers), heart failure and congenital heart surgery. More...
Published: Feb 4, 2014 2:11:08 PM
Report National Audit of Percutaneous Coronary Interventional (PCI) procedures 2012
published January 30th 2014.
Expansion in the use of Percutaneous Coronary Intervention (PCI) is seeing more patients with acute coronary syndromes treated more quickly, according to the latest National Audit of PCI (covering 2012). Key findings from the report include: More...
Published: Jan 30, 2014 8:09:31 AM
Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK
The Myocardial Ischaemia National Audit Project (MINAP), from which the data for the Lancet paper was obtained, continues to collect detailed information about the care provided to patients with heart attack. This demonstrates the commitment of participating clinicians, Trusts and governments to improvements in quality of care. While important improvements have been made since 2010, the end of the period studied by the researchers, there is no room for complacency. We need to continue emphasising both the provision of the best modern care, and the recording of that care. We also need to shift from publishing details of the process of care to the outcomes of care. It is our intention to produce a preliminary report of outcomes for each hospital this year. More...
Published: Jan 23, 2014 10:33:12 AM
The British Society of Heart Failure has chosen to initially focus on auditing care within secondary care with a view to extending into primary care in the future.
The need to extend the scope to primary settings has also been highlighted in the Healthcare Commission Report "Pushing the Boundaries: Improving services for people with heart failure (2007)" .
The aims of audit
The audit assesses both clinical care and patient related outcomes and:
- Identifies the percentage of people admitted to hospital with heart failure who have quality of care recorded
- Describes current clinical practice in heart failure diagnosis, care and treatment and to explain variation in practice using data on patient characteristics and access to services.
- Describes the following patient outcomes: length of stay, in-hospital mortality and late mortality (up to one year post discharge).
The audit measures the quality of care for all unscheduled admissions to hospital, where the patient is discharged with a primary diagnosis of heart failure using the following codes:
I50.0 Congestive heart failure
I50.1 Left ventricular failure
I50.9 Heart failure, unspecified
I11.0 Hypertensive heart disease with (congestive) heart failure
I42.0 Dilated cardiomyopathy
I25.5 Ischaemic cardiomyopathy
I42.9 Cardiomyopathy, unspecified.
Note that elective admissions (e.g. admission for angiography or schedules pacemaker implantation) should not be included in the audit.
The most effective way of ensuring all patients treated for heart failure are included in the audit is to use discharge codes and input data from patient notes. A proforma for collecting data is available on the dataset page.
Some hospitals will initially identify patients who are referred to cardiology or HF specialist services. In addition, the coding department highlight all cases on a monthly basis. Missed cases have helped clinical teams identify patients who were not referred to the service. This information has helped to improve the referral process.
Data can aso be imported from existing IT systems (either in-house or via third party IT suppliers) to provide direct data links to the heart failure database.
Number of cases
Initially, the focus of the audit was to ensure that all Trusts were registered and submitting data. The audit now aims to capture all cases of heart failure, so hospitals should include all unscheduled admissions to hospital with a primary discharge diagnosis of heart failure. The audit will compare the number of cases submitted to the audit with expected cases (based on HES discharge data) to monitor case ascertainment.
There are a number of data entry validation checks in the audit application to ensure that contradictory and impossible data cannot be submitted (e.g. invalid dates, clinical contradictions). The audit will contact hospitals with poor data quality, for example, where 'unknown' is overused, or where core non-mandatory fields are missing. Before any outcome data is published data hospital level, preliminary analyses will be sent to all clinical leads to ensure that the data submitted to the audit is correct. However hospitals are ultimately responsible for the quality of the data that they include in the audit.
The National Heart Failure Audit dataset reflects the following clinical indicators:
- ESC Guidelines for the diagnosis and treatment
of acute and chronic heart failure 2012 (pdf)
- NICE Chronic heart failure quality standard (2011)
- NICE Clinical Guidelines 108: Chronic Heart Failure (2010)
- National Service Framework for Coronary Heart Disease (2000) (pdf)
Page last modified on 11 dec 13 10:16