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Adherence to Get With The Guidelines initiative associated with lower mortality for some patients
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Hospitals adhering to provisions laid out in the Get With The Guidelines quality enhancement initiative were associated with lower 30-day mortality among patients with acute MI as well as patients with HF.
Researchers examined data from 3,909 hospitals reporting 30-day mortality. Among those, 355 (9%) received Get With The Guidelines achievement awards for maintaining at least 85% performance on each recommended process of care for at least one year. The 30-day mortality data for patients with HF and those with acute MI were reported separately.
Hospitals receiving awards were more likely to be acute care hospitals (99% acute care, 1% critical access/rural) compared with nonaward hospitals (82% acute care, 8% critical access hospitals). The 30-day risk-adjusted mortality was 11.2% after admission with HF and 16.4% after admission for acute MI. Risk adjusted mortality for hospitals that received awards was lower for both HF vs. those hospitals that did not receive awards. After additional adjustment for hospital characteristics, the decrease in 30-day mortality remained for acute MI (P=.01) but diminished for HF admissions (P=.11). When mortality rates were further adjusted for performance on process of care measures, the benefit of awarded hospitals was reduced by 28% for HF mortality and 43% for acute MI mortality.
“Our study demonstrated that hospitals receiving performance achievement awards from the Get With The Guidelines program had better process of care and risk-adjusted 30-day mortality for HF and CAD,” the researchers concluded. “While hospital characteristics explained some of this reduction in mortality, improved process of care was also an important factor, particularly for acute MI hospitalization. Our study provides evidence that quality improvement programs that improve process of care for heart disease may also improve patient outcome.”
Heidenreich PA. Am Heart J. 2009;158:546-553.