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Table 3 Description of baseline and follow-up strategies (N = 72 Hospitals)

From: Strategies to reduce hospital 30-day risk-standardized mortality rates for patients with acute myocardial infarction: a cross-sectional and longitudinal survey

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%)  
  1. 1Number of missing responses range from 0 to 3.
  2. 2Number of missing items range from 3 to 5; one item missing 10.
  3. 3Tests of symmetry used.