Quality
Quality Outcomes
Heart Attack
| Heart Attack Quality Measures1 | St. Clair results | National results |
|---|---|---|
|
Percent of heart attack patients given aspirin upon arrival
Higher percentages are better
|
99% |
99% |
|
Percent of heart attack patients given aspirin at discharge
Higher percentages are better
|
100% |
99% |
|
Percent of heart attack patients given ACE inhibitor or ARB for left ventricular systolic dysfunction
Higher percentages are better
|
88% |
97% |
|
Percent of heart attack patients given beta blocker at discharge
Higher percentages are better
|
98% |
99% |
|
Percent of heart attack patients who receive PCI within 90 minutes of arrival
Higher percentages are better
|
98% |
92% |
1 Results are from patients who had overnight hospital stays from April 1, 2010 through March 31, 2011. Source: U.S. Department of Health and Human Services
Aspirin on Arrival
What are we measuring?
How frequently patients who come to the hospital with a heart attack are given an aspirin on arrival in the Emergency Department
Why is this important?
Aspirin can help prevent clots from forming or help dissolve clots that have formed. Studies show that taking an aspirin as soon as the symptoms of a heart attack begin may decrease the severity of the attack.
How are we doing?
St. Clair’s outcomes trend comparably to national averages. Our team of physicians and nurses continue to analyze and enhance our processes. As a result, the Emergency Department has instituted new standardized order sets and protocols so eligible patients receive aspirin therapy.
Aspirin upon Discharge
What are we measuring?
How frequently patients are discharged from the hospital with instructions to take aspirin at home
Why is this important?
Aspirin can help prevent clots from forming or help dissolve clots that have formed. Studies show that continued use of aspirin following a heart attack may reduce the risk of another heart attack.
How are we doing?
Although our results are better than the national average, our team of physicians, nurses and pharmacists continue to analyze our process for discharge instructions.
ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction
What are we measuring?
How frequently patients with left ventricular systolic dysfunction are prescribed a medication called an angiotensin converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) early in the hospitalization.
Why is this important?
ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are medicines used to treat patients with heart failure and are particularly beneficial in those patients with decreased function of the left side of the heart. Early treatment with ACE inhibitors and ARBs can also reduce the risk of death from future heart attacks. Since the ways in which these two kinds of drugs work are different, your doctor will decide which drug is most appropriate for you.
How are we doing?
St. Clair’s results are not trending as strong as the national average. Upon thorough evaluation, it was discovered that physicians are evaluating their patients for LVSD, but at times are not completing the required documentation of their treatment decisions. Policies have been enacted to rectify this process.
Beta Blocker upon Discharge
What are we measuring?
How frequently patients who meet medical indications are prescribed a beta blocker upon discharge
Why is this important?
Beta blockers are a type of medicine that is used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on your heart by slowing the heart rate and reducing the force with which your heart muscles contract to pump blood.
How are we doing?
St. Clair’s outcomes are at the national average. Our physicians follow American College of Cardiology guidelines for prescribing this medication. Nurses and pharmacists instruct patients how to take the medication at home and the potential side effects.
Percutaneous Coronary Interventions (PCI)within 90 Minutes
What are we measuring?
How frequently patients who are undergoing an angioplasty procedure have their culprit coronary artery ― the artery causing the heart attack ― opened within 90 minutes of arrival at the Hospital.
Why is this important?
PCI are procedures that are among the most effective ways to open blocked blood vessels and help prevent further heart muscle damage. Improving blood flow to your heart as quickly as possible lessens the damage to your heart muscle. It increases your chances of surviving a heart attack. Based on scientific research, the American College of Cardiology recommends that “door-to-balloon-time” take no longer than 90 minutes from hospital arrival to completion of the procedure.
How are we doing?
Our results show that we greatly exceed the national average for this measure. Our Door to Balloon Team of ED physicians, interventional cardiologists, ED staff Cardiac Cath Lab staff, and EMS services have designed the quickest pathway for patients to receive heart saving interventional procedures. This pathway includes pre-hospital ECG by EMS units who take command from the St. Clair ED physicians.