Wasser T, Rossi M, Mawji Z, Parker P, Fritz K, EID S, Masiado T; AcademyHealth. Meeting (2005 : Boston, Mass.).
Abstr AcademyHealth Meet. 2005; 22: abstract no. 3963.
Lehigh Valley Hospital, Health Studies, 5754 Loyola St., Macungie, PA 18062 Tel. 610-402-2497 Fax 610-402-2247
RESEARCH OBJECTIVE: Get With the Guidelines (GWG) was developed and piloted by the American Heart Association (AHA) to reduce the gap in the application of secondary prevention guidelines in Hospitalized cardiovascular disease patients. The Progress Note Sheet was developed using quality measures derived from the AHA/American College of Cardiology secondary prevention guidelines. It provided data entry, and included guideline summaries. STUDY DESIGN: Our hospital collected data on the efficacy of utilizing the Progress Note Sheets as an intervention. While the program at our hospital will last a year, this abstract contains the first six weeks of outcome data from this study. These data were analyzed comparing those patients who had a Progress Note Sheet administered against those patients who did not. Quality of care indicators included: Aspirin given in the first 24 hours of admission, Aspirin ordered for discharge, Beta Blocker (BB) given in the first 24 hours of admission, BB ordered for discharge, ACE 1 ordered if LVEF less tan 40%, Smoking cessation advised for patient if current or recent tobacco user for Acute Myocardial Infarction (AMI) patients. Results were computed using Chi-square and Fisher;s exact test when samples were small. Any p-value less than 0.05 was considered significant for this analysis. POPULATION STUDIED: GWG eligible patients were enrolled for the first six weeks of the program from (August 15, 2004 through September 30, 2004). Data for the study were collected by two RN, grant funded researchers. PRINCIPAL FINDINGS: The early results indicated that the GWG Progress Note implemented as an intervention was effective in all key areas. Administering BB within 24 hours of admission increased by 12.2% (p=0.041), and at discharge increased by 5.5% but not yet significant (p=0.227). Administering aspirin within 24 hours of admission increased by 6.1% (0.115). Discharge instructions, and home advisors given to patients increased by more than 50% (p<0.001). Other indicators that are demonstrating positive findings but not yet significant were; administering aspirin at discharge increased by 2.6%, ACI orders increased by 8.8% for AMI patients and 16.6% for CHF patients Smoking cessation counseling increased also by 3.3% in AMI patients and 37.5% in CHF patients. CONCLUSIONS: Sound intervention methodology suggests that the process indicators and outcomes be monitored early and often within program implementation so that adjustments can be made to the program as needed. In this program implementation the GWG program has increased the quality of care for CHF and AMI patients. This study focuses on only the first six weeks of the year long program but results are already promising. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: While this study has only been in place for six weeks, early indications are in the positive direction. And data for some indicators are already achieving significance. Early results indicate that GWG intervention improves compliance on core measures for AMI patients.
Publication Types:
Keywords:
- Acute Disease
- Adrenergic beta-Antagonists
- American Heart Association
- Aspirin
- Cardiology
- Cardiology Service, Hospital
- Guidelines as Topic
- Heart Failure
- Hospitals
- Humans
- Medical Audit
- Myocardial Infarction
- Patient Discharge
- Practice Guidelines as Topic
- methods
- standards
- hsrmtgs
UI: 103623426
From Meeting Abstracts