IM Québec. Comité de Cardiologie Tertiaire, RUIS U. de Montréal. RUIS U. McGill RUIS U. de Sherbrooke RUIS U. Laval. Erick Schampaert, M.D.
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1 IM Québec Comité de Cardiologie Tertiaire, RUIS U. de Montréal RUIS U. McGill RUIS U. de Sherbrooke RUIS U. Laval Erick Schampaert, M.D.
2 IM Québec Introduction IM Québec is a quality medical care evaluation project, using a prospective online database, providing real-time analytic feedback to providers, in order to optimize care Population ALL STEMI Identified by ECG (E.R., Pre-hospital EMS) Regardless of reperfusion (or lack of) or outcome 2
3 IM Québec Hypothesis A structured network, involving all care providers, will provide optimal care for STEMI Primary Objectives Facilitate the establishment of a structured network Minimize reperfusion delays, according to RQCT 3
4 IM Québec Hypothesis A structured network, involving all care providers, will provide optimal care for STEMI Primary Objectives Facilitate the establishment of a structured network Minimize reperfusion delays, according to RQCT 4
5 IM Québec Hypothesis A structured network, involving all care providers, will provide optimal care for STEMI Primary Objectives Facilitate the establishment of a structured network Minimize reperfusion delays, according to RQCT Optimize STEMI clinical outcomes 5
6 Historical Perspective ETAIMEST : November 2008: Suboptimal reperfusion delays Comité de Cardiologie Tertiaire U. de M. (CCTRUM): Jan. 2009: RUIS U. de M. : Priority (Busilacchi, Rouleau) CCTRUM - AMI-Québec MHICC (ARO): Fall 2009 Single Database (IM Québec, AMI OnTime (Primary PCI):
7 7
8 Provincial collaboration: RUIS U. de Montréal AMI-Québec: Dr. Huynh RUIS U. de McGill: Drs.Huynh, Genest and Ms. Lynch RUIS U. de Sherbrooke: Dr. Nguyen RUIS U. de Laval: Drs. DeLarochelière, Rinfret et Dery Academic Research Organization: MHICC: Dr. Tardif
9 ARO: MHICC
10
11
12 IM Québec: Sous-comité CCTRUM Mme Lucette Whittom Project Leader, RUIS de l Université de Montréal , lucette.whittom@videotron.ca Mme Stéphanie Lamothe Database Leader, Montreal Heart Institute Coordinating Ctr (MHICC) poste 3595, stephanie.lamothe@mhicc.org M. Benoit Pronovost Database laeader, MHICC poste 2048, benoit.pronovost@mhicc.org Drs. P. L Allier, A. Vadeboncoeur, S. Kouz, JF Gobeil, J Diodati Dr. Erick Schampaert, RUIS de l Université de Montréal, Hôpital Sacré-Cœur de Montréal, , erick.schampaert.hsc@ssss.gouv.qc.ca 12
13 IM Québec: Sous-comité CCTRUM September 2010 Presentations, Training and Support to the 6 Agences and their institutions of U. de M.: 1-2 Project presentations visits, per Agence Training and Support visits: Agence Montréal : 17 et 23 février 2010 Agence Laurentides : 07 avril 2010 Agence Laval: 14 juin 2010 Agence Lanaudière : 08 février, 25 mars et 3 aout 2010 Agence Montérégie: 12 mai et 02 juin 2010 Agence Mauricie, Centre du Québec : 14 déc. 2009, Sept 2010 Including all regional EMS 13
14 IM Québec: Sous-comité CCTRUM September 2010 Direct Impact: Individual Local STEMI team: Assessment and optimization of current strategies Baseline and CME EMS network STEMI registry and monitoring: Data entry Regional STEMI team: Mauricie, Montérégie 14
15 IM Québec: Sous-comité CCTRUM September 2010 Database initiation: May 26, 2010 September 26: 670 IM Québec patients (2000 pts/y, 50% all STEMI) 42 institutions in 6 Agences RUIS U. de M.: 28 institutions RUIS U. de M. 11 institutions RUIS U. de M. RUIS McGill (Montréal et Montérégie) 3 institutions RUIS U. de M. RUIS Sherbrooke (Mauricie et Montérégie) 15
16 IM Québec: Sous-comité CCTRUM September 2010 Database initiation: May 26, 2010 September 26: AMI-OnTime: 352 patients (288 IM Québec pts) 13 institutions w Cath. Lab., providing PPCI: 6 institutions (RUIS U. de Montréal): 228 patients 2 institutions (RUIS U. McGill): 60 patients 2 institutions (RUIS U. Laval): 64 patients 1 institutions RUIS Sherbrooke 1 institutions RUIS McGill : Hull 1 institutions RUIS Laval: Chicoutimi 16
17 IM Québec: Sous-comité CCTRUM September 2010 Exclusions: 36/734 patients: 4.9% Exclusion: Non STEMI C.P. > 12 hrs Péricarditis Test patient into the active database Local STEMI Registry: E.R. + Archives 17
18 IM Québec: Sous-comité CCTRUM September 2010 Statistiques: EMS: 56% completed CRF 0.8% correction request In-Hospital: 60% completed CRF 0.6% correction request 18
19 IM Québec: Sous-comité CCTRUM September 2010 Live Periodical Feedback: Online institutional access: September: institutional preliminary reports October: more robust analyses, reperfusion delays November: regional reports, including EMS Institutions w Cath. Lab.: 2 reports Local Referring centres 19
20 IM Québec: Sous-comité CCTRUM Short Term Objectives: Web-Conference: RQCT recommendations : Oct. 20, 2010 IM Québec at CCC 2010, Montréal RQCT presentation: annual meeting, Nov. 3,
21 IM Québec: Mid-Term Objectives: Representative committee: Fall 2010 Remaining RUIS McGill institutions: Winter 2011 Remaining RUIS Sherbrooke institutions: Winter 2011 Random monitoring: Winter 2011 Database collection amendment: Spring
22 IM Québec: Mid-Term Objectives: Complete Quebec adoption: All 4 RUIS EMS Obtain MSSS financial and structural long-term support 22
23 AMI-Québec AMI-OnTime Quality Medical Care Evaluation AETMIS Clinical Research? IM Québec??? CAI
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