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Clinical Quality and Outcomes

Quality and Safety of care are the cornerstone of our services

GKNM Hospital was the first Hospital in Tamilnadu to be accredited by the ‘National Accreditation Board for Hospitals and Healthcare Providers’.

Quality excellence and safety programs are implemented for both medical and nonmedical departments. Data is closely monitored and outcomes are shared with the Staff for continual improvement. A hospital which has checks and balances is always viewed upon with respect. Our audit programs are indeed models of Quality assurance.

1. Quality measures for Paediatric cardiac surgery

What does it mean?

The Paediatric cardiothoracic services of G.Kuppuswamy Naidu Memorial Hospital participates in the International Quality Improvement Collaborative for Congenital Heart diseases (IQIC). All data submitted is verified and validated by the team from Boston children`s Hospital. The annual benchmarking report of IQIC allows to track performance and compare our
results with our IQIC partners.

Parameters in Paediatric
Cardiothoracic surgery		Benchmark
International Quality Improvement Collaborative (IQIC) data Combined 38 sites		GKNMH data 2022
In hospital mortality4.6%1.2%
Surgical site infection2.4%0.2%
Bacterial sepsis5.1%0.2%
CLABSI0.4%0%
CAUTI0.3%0%
VAE1.1%0%
Additional surgery for bleeding1.4%0%
30-day mortality4.8%4.8%

2. Door - to - balloon time among patients who have presented with acute ST segment elevation Myocardial infarction ( STEMI)

What does it mean?

‘Door to balloon time’ is a phrase that denotes the a time between arrival of a patient with STEMI in the emergency room until the time that a ballon is inflated in the occluded, culprit coronary artery. Prompt percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI) significantly reduces mortality and morbidity.

ParameterBench MarkGKNMH data 2023
Door to balloon time within 90 mins in patients presenting in ER who underwent PCI for ST segment elevation myocardial infarction (STEMI).American College of Cardiology and the American Heart Association (ACC–AHA)Average door to balloon time among patients who presented with ST segment elevation myocardial infarction and gave an early consent: 88.38 in min

3. Quality measures for adult Cardiothoracic surgery

3a. Percentage of unplanned return to cardiothoracic operation theatre
What does it mean?

Unplanned return to the operating theatre (OT) is defined as a return of the patient to the operation theatre due to complications or untoward outcomes related to the initial surgery.

ParameterBench MarkGKNMH data 2023
Percentage unplanned return to Cardio thoracic OT2.2 % (Cleveland clinic cardiac surgery performance data, 2019)
2.2- 3.2 % (STS database, 2019)		2.6%
3b. Percentage postoperative prolonged mechanical ventilation following isolated coronary artery bypass graft (CABG) surgery.
What does it mean?

Prolonged mechanical ventilation (defined as > 24 hours) is a major complication following cardiac surgery. It is an independent predictor for readmission to the ICU following CABG surgery. Shorter ventilation times are linked to high quality of care.

ParameterBench MarkGKNMH data 2023
Postoperative Prolonged Ventilation following isolated CABG4.4% (Cleveland clinic cardiac surgery performance data, 2019)
13.3 % (STS database, 2019)		2.03 %
3c. Incidence of stroke post isolated CABG
What does it mean?

Stroke is one of the most devastating complications after coronary artery bypass graft (CABG) surgery, entailing permanent disability, a 3–6-fold increased risk of mortality, an increased cost of hospitalisation and a longer length of hospital stay.

ParameterBench MarkGKNMH data 2023
Percentage of patients who had a post-operative stroke following an isolated CABG0.9 % (Cleveland clinic cardiac surgery performance data, 2019)
1.3 – 2.1 % (STS database, 2019)		1.44%
3d. Reintubation rate within 48 hrs of extubation among patients of isolated coronary artery bypass graft (CABG) surgery.
What does it mean?

There is evidence that extubation failure and reintubation can worsen outcome and is associated with an increased risk of morbidity and mortality.

ParameterBench MarkGKNMH data 2023
Reintubation rate within 48 hrs of extubation.Department of Critical Care Medicine, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India 3.5%.1.43%
3e. 30-day mortality after isolated CABG
What does it mean?

This indicator calculates the risk-adjusted rate of all-cause deaths occurring within 30 days for patients undergoing an isolated coronary artery bypass graft (CABG) surgery. Lower rates are desirable.

ParameterBench MarkGKNMH data 2023
30-day mortality after isolated CABG:1.4 % (Cleveland clinic cardiac surgery performance data, 2019)
3.0 % (US National rate, 2019)		1.59%

4. Complication rate in image guided interventions

What does it mean?

Image-guided percutaneous needle biopsy (PNB) is an established, effective procedure for selected patients with suspected pathology. While practicing, physicians should strive to avoid complications during this diagnostic procedure.

ParameterBenchmarkGKNMH data 2023
Complication rate in image guided interventionsOverall threshold: Lung Procedures – 10%, Others 2%
American College of Radiology		0.18%

5. Healthcare Associated Infection Data

What does it mean?

The role of infection control is to prevent and reduce the risk for hospital-acquired infections. This can be achieved by implementing infection control programs in the forms of surveillance, isolation, outbreak management, environmental hygiene, employee health, education, and infections prevention policies and management. The major direct complication of an inappropriately managed infection control program is infection risk for the patient.

ParameterBenchmark (International Nosocomial Infection Control Consortium (INICC) India 2017).GKNMH data 2023
Surgical Site Infection (SSI)4.2%1.79%
Catheter Related Blood stream Infection (CLABSI)4.1/1000 device1.59/1000 device days
Ventilator Associated Pneumonia (VAP)9.4/1000 device days1.51/1000 device days
Catheter related Urinary tract infection2.9/1000 device days1.16/1000 device days
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