The Challenge of Designing Key Performance Indicators for Academic Hospitals: Quality of Care for Patients with Ischemic Heart Disease

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Ibtisam M. Jali
Kamal W. AlGhalayini
Wesam A. Alhejily
Mohammed S. Abdulwahab
Mohamed N. AlAma
Hind I. Fallatah
Hani A. Jawa
Yousef A. Qari
Salim M. Bazarah
Ahmed A. Al Johaney
Siraj O. Wali
Ayman K. Sanosi
Aysha A. Alshareef
Omar A. Ayoub
Abdulraheem M. Alshehri
Mohammed A. Almekhlafi
Shadi S. Alkhayyat
Atlal M. AbuSanad
Nisreen F. Bajnaid
Omar A. Fathaldin
Sami M. Bahlas
Amani M. Alhozali
Hala H. Mosli
Kholoud A. Ghamri
Nawal N. Binhasher
Fatma I. Al Beladi
Hanadi M. Alhozali
Rana A. Nablawi
Mohammed A. Basheikh
Tareef Y. Al Aama
Faten N. Al Zaben
Fahad E. Alsulami
Aroub A. Alkaaki


Key performance measures, Ischemic heart disease, Outcome, Readmission, Intensive care unit transfer


Background: This study assesses whether patients with ischemic heart disease receive comparable care and achieve similar outcomes compared to the rest of patients in the department of medicine at our tertiary academic center.

Methods: This retrospective study examined the level of care received by all patients who were admitted to the Internal Medical Services at King Abdulaziz University Hospital from January 2010 through December 2012. A number of potential performance indicators were evaluated to ascertain level of care, including clinical deterioration with unplanned intensive care unit transfers, in-hospital complications, in-hospital mortality, and the rate of 30-day readmission. The t test or Mann-Whitney U-test was used to compare means and medians, respectively. The chi-square test was used to compare categorical variables.

Results: Of 3838 patients, about a fifth of ischemic heart disease patients (19.3%) required intensive care unit transfer (P < 0.001). Patients admitted through the emergency department were the largest group to require subsequent intensive care unit transfer (65.9% of all cases). The length of stay was significantly shorter in patients admitted to the cardiac care unit, compared with those admitted to other services (3.5 [1.5] days versus 5.8 [5.5] days for patients admitted to other units; P < 0.001). Thirty-day readmission rate was significantly lower in ischemic heart disease patients (11.7%) compared with non- ischemic heart disease cases (18.5%) (P < 0.0001).



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