# Peer learning to promote quality and appropriate use of percutaneous coronary intervention

> **NIH VA IK2** · VA PUGET SOUND HEALTHCARE SYSTEM · 2022 · —

## Abstract

Dr. Jacob Doll, MD is a Staff Interventional Cardiologist at the VA Puget Sound Health Care System,
Acting Assistant Professor in the University of Washington Department of Medicine, Core Investigator at the
Seattle HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, and Assistant Director of
the VA Clinical Assessment, Reporting, and Tracking (CART) program. The proposed Career Development
Award (CDA) will benefit Veterans by improving the delivery of invasive cardiac care through peer learning
strategies, while provide the training and support Dr. Doll needs to become a leader in performance evaluation
and feedback and to drive innovation in cardiovascular procedural care.
 This research will develop and test a peer learning intervention that promotes percutaneous coronary
intervention (PCI) care quality. PCI, also known as “stenting,” is a common cardiovascular procedure that can
improve survival and quality of life when used appropriately. However, clinical outcomes vary significantly
among hospitals and physicians. Nearly all PCI procedures in the US are reported to national registries for
quality improvement purposes, including the CART program. Despite this wealth of clinical data and substantial
investment of time and resources to PCI quality, physicians who perform PCI are not receiving meaningful
feedback about their practice. Improved methods of audit and feedback are needed. Peer learning is a
collaborative quality improvement method that provides detailed, personalized, and actionable feedback to
clinicians from their colleagues. The performance of unnecessary PCI procedures and the technical quality of
procedures are of particular interest to VA. Of elective procedures performed at VA, only 24% are clearly
indicated by appropriateness criteria, potentially putting patients at risk without benefit. The nominee for this
CDA therefore proposes to design and test a peer learning intervention that promotes PCI quality and
appropriate case selection.
 The specific aims of the proposal are: 1) Identify barriers and facilitators to the use of peer learning
through surveys and semi-structured interviews with VA PCI operators and key stakeholders; 2) Develop and
refine a peer learning intervention that provides usable and acceptable feedback to PCI operators; and 3) Pilot
test a peer learning intervention to assess and improve PCI case selection and technical performance. This
research will directly benefit Veterans and the VA system by improving the quality of PCI and increasing the
frequency of appropriate PCI, thereby maximizing benefit while avoiding unnecessary procedural risks and
costs. It will build on the extensive ongoing investment in the CART program by developing a novel method for
promoting clinical practice change. Finally, it will develop methods of peer learning that are broadly applicable
to other fields. The research program will lead directly to a multi-site randomized controlled trial and ultimately
to ...

## Key facts

- **NIH application ID:** 10415871
- **Project number:** 5IK2HX002590-04
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Jacob A Doll
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10415871

## Citation

> US National Institutes of Health, RePORTER application 10415871, Peer learning to promote quality and appropriate use of percutaneous coronary intervention (5IK2HX002590-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10415871. Licensed CC0.

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