Program highlights need for high-quality hospital care of acute MI, HF

Wang T. J Am Coll Cardiol. 2011;doi:10.1016/j.jacc.2011.05.012.

Issue: September 2011

New data examining the effect of the American Heart Association’s Get with the Guidelines program have shown that patients who went to hospitals with superior performance for the care of both acute MI and HF had lower rates of mortality vs. those who went to hospitals with superior care of one or neither of those conditions.

Tracy Y. Wang, MD, and fellow study researchers looked at hospital performance using core measures of the CMS. The analysis included 283 hospitals that submitted 10 or more patients to the Get with the Guidelines (GWTG) acute MI and HF programs from 2005 to April 2009. Superior adherence was defined as the upper tertile of performance for each set of metrics.

Overall, hospital adherence to core measures was similar for HF (92%) and acute MI (93%). Hospitals that performed superiorly in both HF and acute MI processes reported a longer participation in the GWTG program and, most importantly, a reduction in adjusted in-hospital mortality (OR=0.79; 95% CI, 0.63-0.99) for both measures compared with hospitals with superiority in neither. However, hospitals that had superior adherence to only one had a comparable rate of mortality vs. hospitals with superior adherence in neither measure.

Part of the reason for these observations, the researchers wrote, may have to do with the higher length of time of participation in the GWTG program observed in hospitals with superior processes for both measures. “Superior adherence to both acute MI and HF measures simply may be a marker of hospitals with early interest and action in quality improvement,” they said.

In concluding their findings, the researchers said future investigation and refining of quality improvement strategies are needed to optimize the consistency of hospital quality of CV care.

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