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Table 3 Monitoring overview

From: Selecting interventions to improve patient-relevant outcomes in health care for aortic valve disease – the Intervention Selection Toolbox

MONITORING IMPROVEMENT
TreatmentIndicatorInitiativeBased on outcome measures yes/noHow did it take place?Implementation dateIntended impact on which outcomeImplementation completion (%)How is it measured?
TAVR30-day mortality1) Pre-TAVR/frailty outpatient clinic started in 2014, 2) TAVR complication discussion started in 4th quarter 2014 with the following issues discussed: A) Choice of valve selection, B) Creation of a specialization team, C) Add additional CT images in report to the TAVI Team.yes 1st quarter 201530-day mortality100%Valve choice: registry measured
1-year mortalityPre-TAVR/frailty outpatient clinic started in 2014yes 4th quarter 20141-year mortality100%Not
long-term survivalProposal change training plan - development of online course small private online course for residents with focus on frailty, functional decline and shared decision makingnospecific project team for elderly care4th quarter 2015none0%Not
Vascular complications1) Routine CT scan required pre-TAVR, 2) Start study new closing device in 2015, 3) Start complication discussions in 4th quarter 2014, where it was discussed to lower the threshold for a surgical cut downyes 4th quarter 2014Vascular complications100%Not
SAVRRe-sternotomyCoagulation policy: Optimization of the transfusion policy based on for example the TEGa at the operation room, or no coagulation correction. In addition, the aim is to reduce the number of blood transfusions. The number of re-sternotomies could decrease at a targeted corrected clotting status of the patient.noInitiative from Anesthesiologists who conducted research1st quarter 2015Bleeding complications50%As part of a study
  1. aTEG thromboelastography for testing the efficiency of blood coagulation
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