Tags

Type your tag names separated by a space and hit enter

A statewide collaborative initiative to improve the quality of care for patients with acute myocardial infarction and heart failure.
Circulation. 2009 Mar 31; 119(12):1609-15.Circ

Abstract

BACKGROUND

To enhance quality improvement, we created a unique statewide collaboration among 3 organizations: the Virginia Health Quality Center (Virginia's Medicare Quality Improvement Organization), the American College of Cardiology, and the American Heart Association. The goal was to improve discharge measures for acute myocardial infarction and heart failure.

METHODS AND RESULTS

In 2004, 29 hospitals participated in the collaborative initiative. Using Medicare data submitted from 2004 through the second quarter of 2006, we analyzed adherence to individual discharge measures and all-or-none appropriate care measures for acute myocardial infarction, heart failure, and both. To control for differences in hospital characteristics, we were able to match 21 of the participating hospitals with 21 similar nonparticipating hospitals. In this paired analysis, the total appropriate care measure increased from 61% to 77% in participating hospitals compared with an increase from 51% to 60% in nonparticipating hospitals (P<0.0001). A generalized linear mixed model examining the full data set at the patient level failed to show a clear advantage among participating hospitals. Participating hospitals had higher baseline rates for most quality measures, suggesting a possible effect of a prior collaborative. Further analysis of only hospitals that participated in a prior collaborative showed that participants in the current collaborative initiative had higher rates of improvement for 7 of 10 quality measures and appropriate care measures for heart failure, acute myocardial infarction, or both (all P<0.05).

CONCLUSIONS

We report a unique collaboration of a Medicare Quality Improvement Organization and 2 national organizations to address quality of care for acute myocardial infarction and heart failure. A composite measure of quality (the total appropriate care measure) improved more in the participating hospitals during the timeframe of the intervention, although the greater improvement in this and other measures in the participating hospitals appeared to be dependent on participation in a prior collaborative initiative.

Authors+Show Affiliations

Virginia Chapter, American College of Cardiology, Charlottesville, VA, USA. jebrush@earthlink.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

19289632

Citation

Brush, John E., et al. "A Statewide Collaborative Initiative to Improve the Quality of Care for Patients With Acute Myocardial Infarction and Heart Failure." Circulation, vol. 119, no. 12, 2009, pp. 1609-15.
Brush JE, Rensing E, Song F, et al. A statewide collaborative initiative to improve the quality of care for patients with acute myocardial infarction and heart failure. Circulation. 2009;119(12):1609-15.
Brush, J. E., Rensing, E., Song, F., Cook, S., Lynch, J., Thacker, L., Gurram, S., Bonow, R. O., Brough, J., & Valentine, C. M. (2009). A statewide collaborative initiative to improve the quality of care for patients with acute myocardial infarction and heart failure. Circulation, 119(12), 1609-15. https://doi.org/10.1161/CIRCULATIONAHA.108.764613
Brush JE, et al. A Statewide Collaborative Initiative to Improve the Quality of Care for Patients With Acute Myocardial Infarction and Heart Failure. Circulation. 2009 Mar 31;119(12):1609-15. PubMed PMID: 19289632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A statewide collaborative initiative to improve the quality of care for patients with acute myocardial infarction and heart failure. AU - Brush,John E,Jr AU - Rensing,Edna, AU - Song,Frank, AU - Cook,Sallie, AU - Lynch,Janet, AU - Thacker,Leroy, AU - Gurram,Sarat, AU - Bonow,Robert O, AU - Brough,Joani, AU - Valentine,C Michael, Y1 - 2009/03/16/ PY - 2009/3/18/entrez PY - 2009/3/18/pubmed PY - 2009/4/25/medline SP - 1609 EP - 15 JF - Circulation JO - Circulation VL - 119 IS - 12 N2 - BACKGROUND: To enhance quality improvement, we created a unique statewide collaboration among 3 organizations: the Virginia Health Quality Center (Virginia's Medicare Quality Improvement Organization), the American College of Cardiology, and the American Heart Association. The goal was to improve discharge measures for acute myocardial infarction and heart failure. METHODS AND RESULTS: In 2004, 29 hospitals participated in the collaborative initiative. Using Medicare data submitted from 2004 through the second quarter of 2006, we analyzed adherence to individual discharge measures and all-or-none appropriate care measures for acute myocardial infarction, heart failure, and both. To control for differences in hospital characteristics, we were able to match 21 of the participating hospitals with 21 similar nonparticipating hospitals. In this paired analysis, the total appropriate care measure increased from 61% to 77% in participating hospitals compared with an increase from 51% to 60% in nonparticipating hospitals (P<0.0001). A generalized linear mixed model examining the full data set at the patient level failed to show a clear advantage among participating hospitals. Participating hospitals had higher baseline rates for most quality measures, suggesting a possible effect of a prior collaborative. Further analysis of only hospitals that participated in a prior collaborative showed that participants in the current collaborative initiative had higher rates of improvement for 7 of 10 quality measures and appropriate care measures for heart failure, acute myocardial infarction, or both (all P<0.05). CONCLUSIONS: We report a unique collaboration of a Medicare Quality Improvement Organization and 2 national organizations to address quality of care for acute myocardial infarction and heart failure. A composite measure of quality (the total appropriate care measure) improved more in the participating hospitals during the timeframe of the intervention, although the greater improvement in this and other measures in the participating hospitals appeared to be dependent on participation in a prior collaborative initiative. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/19289632/A_statewide_collaborative_initiative_to_improve_the_quality_of_care_for_patients_with_acute_myocardial_infarction_and_heart_failure_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.108.764613?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -