title: Implementation of Measures to Improve SCIP Perioperative Beta-Blocker Compliance: Quality and Financial Implications.
abstract: BACKGROUND
  The Surgical Care Improvement Project (SCIP) was launched in 2005. One of the SCIP metrics includes perioperative beta-blocker guideline (CARD-2), which measures the percentage of patients on a pre-operative beta-blocker with continued use in the perioperative period. Compliance is intended to decrease rates of acute myocardial infarction (AMI) and cardiac mortality among high-risk patients. We desired to create low cost, standardized processes on an institutional level to improve compliance with the SCIP CARD-2 metric.
  
  
  METHODS
  We assessed the impact of interventions on provider compliance with the SCIP CARD-2 metric and on simulated impact on institutional cost.
  
  
  RESULTS
  We were able to improve CARD-2 compliance at one hospital within a year of intervention implementation. The hospital decreased its losses due to noncompliance in FY 2014 by $27 273.
  
  
  CONCLUSIONS
  A relatively low cost intervention, aimed at educating providers that utilized existing infrastructure resulted in improved SCIP beta-blocker compliance. Changes in the reimbursement system made at the time of publication demonstrate that reimbursement measures are constantly in flux; tailored interventions based upon our successes may still produce similar results.
authors.affiliation: Author Affiliations: Department of Anesthesia, Pain Medicine and Critical Care, Beth Israel Deaconess Hospital, Boston, Massachusetts (Dr Sutherland); Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts (Mss Beloff and Lightowler, and Dr Kachalia); Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts (Drs Bates and Kachalia), and Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts (Ms Liu and Dr Urman).
authors.forename: Tori
authors.initials: T
authors.lastname: Sutherland
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beloff
authors.forename: Marie
authors.initials: M
authors.lastname: Lightowler
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.forename: Allen
authors.initials: A
authors.lastname: Kachalia
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000191:economics / Q000592:standards*; D019983:Guideline Adherence; D006761:Hospitals; D006801:Humans; D019990:Perioperative Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists