Table 3 Description of baseline and follow-up strategies (N = 72 Hospitals)
Survey Item | Baseline12010 survey N (%) | Follow up22013 survey N (%) | McNemar’s P-value |
|---|---|---|---|
Quality Improvement and Monitoring | |||
Hospital had a QI team devoted to improving inpatient mortality in patients with AMI | 45 (62.5%) | 54 (77.1%) | 0.108 |
Hospital had QI team to improve post-discharge mortality in patients with AMI | 17 (23.6%) | 30 (43.5%) | 0.024 |
Hospital had a designated person or group to review deaths of patients with AMI that occurred during hospitalization | 63 (87.5%) | 58 (84.1%) | 0.607 |
Hospital had a designated person or group to review deaths of patients with AMI that occurred within 30 days of admission | 16 (22.2%) | 25 (36.2%) | 0.163 |
Hospital had a regular ‘morbidity and mortality’ conferences (or another educational session) for discussing individual cases involving patients with AMI | 40 (55.6%) | 35 (51.5%) | 0.851 |
Hospital was part of a regional effort or consortium of hospitals to improve AMI care | 53 (73.6%) | 56 (81.2%) | 0.442 |
Strategies for Pre-Hospital and In-Patient Care | |||
Hospital provided training to EMS providers about AMI care monthly or quarterly | 26 (36.1%) | 42 (60.9%) | <0.001 |
Clinicians from your hospital met with EMS providers to review the care of patients with AMI | 0.458 | ||
Yes, about monthly | 29 (40.3%) | 32 (51.6%) | |
Other than monthly | 43 (59.7%) | 30 (48.4%) | |
Hospital had 1 or more physician or nurse champions focused on improving either inpatient or 30-day mortality in patients with AMI | 0.5183 | ||
Neither physician nor nurse champion | 23 (31.9%) | 17 (24.6%) | |
Nurse champion only | 4 (5.6%) | 1 (1.5%) | |
Physician champion only | 9 (12.5%) | 11 (15.9%) | |
Both physician and nurse champion | 36 (50.0%) | 40 (58.0%) | |
On the inpatient units, hospital had computerized assisted physician order entry | 24 (33.3%) | 57 (82.6%) | <0.001 |
Non-interventional or interventional cardiologists or cardiology fellows were at the hospital 24-hours/day and 7-days/week | 10 (14.5%) | 16 (23.2%) | 0.238 |
Nurses in at least one of your critical care areas were cross-trained to cover in the catheterization laboratory | 12 (16.7%) | 8 (11.6%) | 0.607 |
Which of the following best describes the role of pharmacists in caring for patients with AMI during this time? | 0.9153 | ||
Pharmacists round on all patients in the CCU or with AMI | 32 (45.7%) | 31 (46.3%) | |
Pharmacists do not round, but review the medications of all patients with AMI | 24 (34.3%) | 23 (34.3%) | |
Pharmacists do not have a specific role in the care of patients with AMI | 14 (20.0%) | 13 (19.4%) | |
Organizational Culture | |||
Clinicians are encouraged to creatively solve problems related to AMI care processes. | 1.000 | ||
Never, rarely or sometimes | 12 (16.7%) | 12 (17.7%) | |
Usually or always | 60 (83.3%) | 56 (82.4%) | |
There is good coordination among the different departments involved with the care of patients with AMI. | 0.012 | ||
Never, rarely, or sometimes | 3 (4.2%) | 11 (16.2%) | |
Usually or always | 69 (95.8%) | 57 (83.8%) | |
Clinicians caring for patients with AMI share new evidence-based approaches with the AMI team. | 1.000 | ||
Never, rarely, or sometimes | 14 (19.4%) | 12 (17.7%) | |
Usually or always | 58 (80.6%) | 56 (82.4%) | |
Departments caring for patients with AMI (e.g., cardiology, emergency medicine) communicate easily with each other. | 0.035 | ||
Never, rarely or sometimes | 4 (5.6%) | 12 (17.9%) | |
Usually or always | 68 (94.4%) | 55 (82.1%) | |
Mistakes have led to positive changes in AMI care processes at the hospital. | 0.557 | ||
Never, rarely, or sometimes | 19 (26.4%) | 23 (33.8%) | |
Usually or always | 53 (73.6%) | 45 (66.2%) |