Using the TARRACO Score to Help Guide Referrals of Type II Myocardial Infarctions to a Cardiac Rehab Program: A Quality Improvement Project

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Dinklage, Abby
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Background: Research has shown Type II MIs have an higher overall mortality rate and likelihood of having other cardiac events as opposed to Type I MIs (Chapman, 2016; McCarthy, 2018 ). Despite the poor outcomes of this patient population, there are not many specific guidelines to help reduce adverse events. This could be related to a lack of specific diagnostic coding for Type II MIs from the ICD system until 2017 (CMS, 2017).|Problem: There are no standardized guidelines specifically for Type II MI patients in cardiac rehab programs despite the benefits of cardiac rehab for all types of MIs. This creates an uncertainty in appropriateness for referrals for this patient population to cardiac rehab.|Purpose: The purpose of this project was to improve health outcomes for Type II MI patients by using the TARRACO score as a guide to providers referral process to cardiac rehab.|Methods: Type II MIs incidence and the percentage of those who are referred for cardiac rehab was monitored for twelve weeks before education and implementation of the TARRACO score in an inpatient hospital setting. The TARRACO score was used to score all Type II MIs that were admitted for twelve weeks. A percentage of the Type II MI patients referred to cardiac rehab, post TARRACO scoring, was evaluated. Once the twelve week implementation of the TARRACO score was complete, those who were scored were monitored for adverse outcomes (rehospitalizations and MACE) for an additional 8 weeks. The patients who were referred and attended cardiac rehab were monitored for chest pain episodes, blood pressure stabilization, and heart rate control.|Conclusion(s): The TARRACO score helped to improve a standardization process for cardiac rehab referrals for Type II MI patients in an inpatient setting.
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