This is a healthcare quality improvement study focused on increasing the utilization of arterial grafts in isolated coronary artery bypass grafting (CABG). Evidence indicates that arterial grafts, compared with venous grafts, provide superior long-term patency, which are recommended to use by the clinical practice guidelines. In hospitals where the use of the internal mammary artery as a graft is relatively low(\<90%) among CABG patients, multiple interventions will be implemented to improve its adoption rate. In hospitals where internal mammary artery graft utilization is already high(≥90%), various interventions will be introduced to promote the use of multiple arterial grafts (defined as the use of two or more arterial conduits). The study targets healthcare professionals as the primary subjects of intervention, with no direct interventions applied to patients during the study period. Changes in the internal mammary artery graft utilization rate and the multiple arterial graft utilization rate before and after the intervention will serve as the primary endpoints for evaluating intervention effectiveness in the two types of hospitals, respectively.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
8,700
Hospitals with low usage rates aim to improve internal mammary artery graft utilization through interventions including education, theoretical training, technical training, conference exchanges, and regular feedback on quality monitoring results.
Hospitals with already high usage rates focus on increasing multi-arterial graft usage rates through similar intervention methods such as education, theoretical training, technical training, conference exchanges focus on multi-arterial graft use. The usage rates of multi-arterial graft for each hospital will be regular feed backed.
Hospitals with low usage rates of internal mammary artery: internal mammary artery graft utilization rate
Internal mammary artery graft utilization rate: the utilization rate of at least one internal mammary artery graft in patients received isolated coronary artery bypass grafting.
Time frame: Duration of hospital stay(from date of admission to date of discharge)
Hospitals with high usage rates of internal mammary artery: multiple arterial graft utilization rate
Multiple arterial graft utilization rate: the utilization rate of two or more arterial conduits in patients received isolated coronary artery bypass grafting.
Time frame: Duration of hospital stay(from date of admission to date of discharge)
In-hospital all-cause mortality rate
The in-hospital all-cause mortality rate of patients received isolated coronary artery bypass grafting.
Time frame: Duration of hospital stay(from date of admission to date of discharge)
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