Irving, Texas, March 20, 2000 -- Clinicians at more than 20 hospitals in the Midwest and Northeast are midway through a yearlong project to improve the clinical assessment, management and discharge planning for heart attack patients. The organizations are collaborating as part of the Clinical Advantage program of VHA Inc., a nationwide alliance of community health care organizations and their affiliated physicians.
Although there is ample evidence supporting the most effective and efficient ways for hospitals to treat patients who have had heart attacks, processes and standards of care vary widely. Research studies show that patients in Maine and Massachusetts are more than twice as likely as patients in Oklahoma and Arkansas to receive a proven regimen of beta-blocker medication after heart attacks.
"Where you are when you have a heart attack is the most important initial determinant of care, and that is unacceptable," said Harlen Krumholz, M.D., associate professor of medicine at Yale University School of Medicine.
"Our goal with this effort is to quickly reduce the gap between what we know works in the treatment of heart attacks, and what is conventionally done to treat these patients." Dr. Krumholz is VHA's national chairman for the Clinical Advantage program and a recognized expert in the treatment of acute myocardial infarctions, or heart attacks.
For Reid Hospital and Health Care Services, a 359-bed facility and VHA Partner in Richmond, Ind., a key measurement is the time lapse from a heart attack patient's arrival in the emergency department to the start of cardiac monitoring. According to Skip Meador, director of cardiac services, the average time for this critical period has dropped from 14 minutes last fall to just over nine minutes in January. "All of the evidence shows that the quicker a patient is accurately assessed by EKG, the quicker you can implement the proper course of interventions," Meador said. "We're headed in the right direction, and we're fortunate to have significant involvement and cooperation from key physicians who are advocating change and quickly helping us become a first class center for cardiac care."
Many of the techniques being used in the heart attack initiative and other programs in VHA's Clinical Advantage have been used successfully in manufacturing and other industries, according to Stuart Baker, M.D., VHA's executive vice president for clinical affairs. "To some extent, we're adapting to a clinical setting proven business concepts, such as the Six Sigma standards to reduce cycle times, increase productivity and improve process flow," he said.
In addition to the 22 hospitals currently in the heart attack initiative, 85 VHA- member hospitals are participating in an effort to improve stroke assessment and treatment, and 16 are in a program to reduce medication errors. For the year 2000, plans call for additional Clinical Advantage programs for stroke, heart attack and medication error reduction, and new programs focusing on breast cancer, congestive heart failure, end-of-life care and patient safety.
Hospitals in the heart attack initiative include (alphabetically by state):
Bridgeport Hospital -- Bridgeport, Conn.
The Greenwich Hospital -- Greenwich, Conn.
Hartford Hospital -- Hartford, Conn.
Midstate Medical Center -- Meridien, Conn.
Yale New Haven Hospital -- New Haven, Conn.
Ball Memorial Hospital -- Muncie, Ind.
Columbus Regional Hospital -- Columbus, Ind.
Community Hospitals of Indianapolis -- Indianapolis, Ind.
Deaconess Hospital -- Evansville, Ind.
Floyd Memorial Hospital -- New Albany, Ind.
The Kings Daughters' Hospital -- Madison, Ind.
Parkview Memorial Hospital -- Fort Wayne, Ind.
Reid Hospital -- Richmond, Ind.
Union Hospital -- Terre Haute, Ind.
Concord Hospital, Concord N.H.
Christ Hospital -- Jersey City, N.J.
Genesis HealthCare System -- Zanesville, Ohio
Good Samaritan Hospital -- Dayton, Ohio
Miami Valley Hospital -- Dayton, Ohio
CentraHealth--Lynchburg General Hospital -- Lynchburg, Va.
Mary Washington Hospital, Fredricksburg, Va.
Charleston Area Medical Center -- Charleston, W.Va.
For additional information about heart attacks and their warning signs go to http://www.laurushealth.com.
About VHA's Clinical Advantage
Developed by an interdisciplinary team of experts, VHA's Clinical Advantage uses evidence--based knowledge, innovative rapid improvement methodologies and systems of standardized measurements to quickly raise the level of patient care in VHA health care organizations. The program is specifically designed to accelerate learning, produce sustainable results and break down the barriers to change in clinical improvement. By implementing this ground--breaking program, VHA health care organizations are helping to dramatically increase the quality of care for patients across America.
About VHA
VHA Inc. is a nationwide network of 1,900 leading community--owned health care organizations and their affiliated physicians. The VHA alliance comprises 27 percent of the nation's community hospitals, including many of the nation's largest and most respected institutions. VHA offers programs and services to improve financial and clinical performance, and as a cooperative distributes income annually to members based on their participation. In December 1999, VHA was named one of the "100 Best Companies to Work For" by Fortune.
For more information on VHA, go to http://www.vha.com.