With appropriate intervention and treatment, survival rates can be significantly improved for patients who suffer an acute myocardial infarction. Targeting five Mid-Michigan hospitals, the Coalition—in partnership with the American College
of Cardiology (ACC), the Michigan Peer Review Organization (MPRO), and the five Flint/Saginaw hospitals—developed a program to promote use of the latest cardiovascular science in the treatment of heart attack patients.
Called Guidelines Applied in Practice: Quality Improvement in Acute Myocardial Infarction Care (AMI-GAP), the initiative focused on improving adherence to clinical practice guidelines for the care of myocardial infarction patients. A toolkit containing AMI standard orders, a clinical pathway, pocket guide card, patient information and discharge forms, chart stickers, and hospital performance charts, was distributed to the five participating hospitals. Outcomes were measured by quality indicators that tracked the application of set guidelines.
Results of this initiative were impressive. With AMI standard admission orders in place, a statistically significant improvement for heart attack patients receiving aspirin within 24 hours of admission increased from 81% to 93%, and measurement of LDL cholesterol levels rose from 64% to 82%. When AMI discharge documents were used, the percentage of patients given aspirin and beta blockers at discharge improved from 84% to 98%, and 89% to 100%, respectively. In addition, rates for smoking cessation counseling, dietary counseling, and cholesterol treatment all improved dramatically after the initiative.
AMI-GAP was a successful, evidence-based program that closed the gap between what is known to be good medicine and what is actually practiced in the field, decreased the cost of care, and improved the quality of people’s lives. The results of the project made national headlines, and the outcomes achieved are emerging as standards by which Centers of Excellence are compared nationwide. It also was a significant accomplishment for the Coalition because it was the first time hospital activities had expanded beyond the three local hospitals in Genesee County.