In the first study of its kind, researchers at Yale School ofMedicine show how hospitals can streamline procedures to reduce thetime they take to treat heart attack patients.
The NIH-sponsoredstudy, published in the September Journal of the American College ofCardiology, reports methods for delivery of rapid care based on theexperiences of top programs. Studies have found that while every minutecounts, few hospitals are able to perform at levels recommended bynational guidelines.
To determine how 11 top hospitals, includingYale-New Haven Hospital, achieved their high level of performance, Yaleinvestigators toured facilities and interviewed physicians, nurses,technicians, administrators and others involved in heart attack care.
"Wefound exceptional, innovative approaches to ensuring rapid treatment ofpatients," said lead author Elizabeth Bradley, director of the HealthManagement Program in the Department of Epidemiology and Public Healthat Yale. "We used management techniques and flow charts to defineachievable times for each step."
"Most of the innovations areabout working smarter, not necessarily harder or with more staff," saidstudy senior author Harlan M. Krumholz, M.D., professor of medicine atYale and director of the Center for Outcomes Research and Evaluation atYale-New Haven Hospital. "It is about proper organization and flow,planning and preparing and then communicating to everyone what isexpected and when. We would like to see best practice become typicalpractice."
The "best practices" recommendations involved diverseinnovations across hospital areas including emergency medical services,collaborations to expedite diagnosis and treatment decisions,transporting patients and staffing critical areas.
Thiswork is part of a larger study funded by the National Heart, Lung andBlood Institute and the Patrick and Catherine Weldon Donaghue MedicalResearch Foundation to identify key success factors for improvingquality care in hospitals.
Other authors on the study includedSarah A. Roumanis, Martha J, Radford, M.D., Tashonna R. Webster, RobertL. McNamara, M.D., Jennifer A. Mattera, Barbara Barton, David Berg,Edward L. Portnay, M.D., Harry Moscovitz, M.D., Janet Parkosewich, EricS. Homboe, M.D. and Martha Blaney.
Citation: Journal of American College of Cardiology 46 1236-1241 (September 2005).
Materials provided by Yale University. Note: Content may be edited for style and length.
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