The
West Virginia Coalition for Quality Health Care (WVCQHC),
in cooperation with West Virginia Hospital Association and
West Virginia Medical Institute, is excited about recent
successes in improving care in acute myocardial infarction
(AMI) and Acute Coronary Syndrome (ACS) through the "GAP
in the Mountains" project.
The Cardiovascular Health (CVH) Study Group at WVCQHC, composed
of Family Practitioners, Internists, Emergency Physicians,
Cardiologists and Nurses, has enlisted the expertise of
the West Virginia physicians and hospitals in the development
of the AMI GAP in the Mountains project.
At
each participating hospital, a physician champion and project
leader headed the GAP team that worked together to develop
and/or modify existing hospital documents (protocols for
admission, critical pathways, discharge instructions, patient
contracts, etc.) modeled after sample documents in the AMI
GAP in the Mountains Resource Manual. Enlisting support
from nursing leaders, QA/CQI staff and hospital administrators
at each hospital ensured success.
While
it may have seemed initially like an involved process, it
really only required putting to paper the local treatment
of AMI and ACS, "tweaking" it to insure that best
practice were being offered, and being an advocates for
that practice. Data used for outcome measurement of this
project was the data reported to JCAHO for Core Measures,
CMS for the 7th Scope of Work, or the Quality Initiatives.
Hospitals did not have any additional reporting requirements
to participate in the AMI GAP in the Mountains project.
In fact, using this data to serve more than one function
is a great way to work smarter, not harder.
"GAP
in the Mountains" Participants Compared to Themselves
|
Indicator
|
Baseline
|
Re-Measurement
|
| ASA
- Arrival |
.89
|
.91
|
| ASA
- Discharge |
.84
|
.89
|
| ACEI
for LVSD |
.51
|
.72
|
| Beta
Blocker - Arrival |
.72
|
.81
|
| Beta
Blocker - Discharge |
.77
|
.89
|
| Smoking
Counseling |
.67
|
.82
|
"GAP
in the Mountains" vs. Non-GAP Hospitals
|
Indicator
|
GAP
|
Non-GAP
|
| ASA
- Arrival |
.91
|
.81
|
| ASA
- Discharge |
.89
|
.86
|
| ACEI
for LVSD |
.72
|
.59
|
| Beta
Blocker - Arrival |
.81
|
.83
|
| Beta
Blocker - Discharge |
.89
|
.90
|
| Smoking
Counseling |
.82
|
.72
|
For additional
information, or if you are interested in participating in
this program, please contact Debbie Ruppert RN at 304 344-9744
ext. 1729, or by email at druppert@wvha.org
or Robert Fanning, DO Study Group Chair at (304) 242-1273.
Downloads:
Improving
Quality of Care for Acute Myocardial Infarction: The Guidelines
Applied in Practice (GAP) Initiative, Journal
of American Medical Association article,March 13, 2002.
GAP
in the Mountains Resource Manual/Toolkit
Standing
orders for admission, critical pathways, discharge instructions,
discharge check sheets modeled after sample documents.
(zipped file - 1.2MB)
West
Virginia Coalition for Quality Health Care Presents Results
of "Gap in the Mountains" Project,
West Virginia State Medical Association article, March-April,
2004
Gap
in the Mountains:Improving AMI Care in West Virginia,
Target Quality, Summer 2004
