Hospital Strategies for Reducing Mortality Rates in Acute Myocardial Infarction | Heart and Vascular Health |

My comment:  Useful systems and hospital management best practices to improve the most valuable heart attack performance measure (death) in patients with a heart attack.  By taking these common sense approaches to providing the best care the death rate is lowered by 1.6% at 30 days.


From the Annals article:


Survey of 537 hospitals using data from CMS to determine hospital strategies and hospital mortality risk with AMI (acute MI).

Study evlauated patients  hospitalized with AMI in 2008-9.

Several hospital strategies were significantly associated with lower mortality and taken together were associated with clinically important differences.


These strategies:

1. holding monthly meetings to review AMI cases between hospital clinicians and staff who transported patients to the hospital

2. having cardiologists always on site

3. fostering an organizational environment in which clinicians are encouraged to solve problems creatively

4.  not cross-training ICU nurses for the cardiac catheterization laboratory

5.  having physician and nurse champions rather than nurse champions alone


Fewer than 10% of hospitals reported using at least 4 of these 5 strategies. 

Among the 15 hospitals that employed none of the five, the average 30-day mortality was 15.9%,  In contrast, the six hospitals that used all five had an average rate of 14.3%.


Conclusion: Several strategies, which are currently implemented by relatively few hospitals, are associated with significantly lower 30-day RSMRs for patients with AMI.