Measuring and Improving Inpatient Cardiac Care

By Sandra Fuller, RN

The American Heart Association and the American Stroke Association have developed a new in-hospital, quality-improvement program called Get With the Guidelines. The program won the “2004 Innovation in Prevention Award” from Health and Human Services, as part of the federal government’s current initiative to prevent chronic diseases among Americans and improve quality of life.

Cayuga Medical Center Cardiac Care Services is enrolled in Get With the Guidelines (GWTG). To be eligible to participate in GWTG a hospital cardiac-care program must be well established and accredited, and must have in place certain standard treatment protocols that all cardiac-care providers understand and follow. The hospital must also have sophisticated data-management capabilities for tracking both adherence to quality initiatives and patient outcomes. This capability facilitates the sharing of data among participating hospitals for the purposes of measuring performance.

How does Get With the Guidelines help improve cardiac care?

This national program helps improve in-hospital cardiac care in several ways:

First, the program promotes evidence-based treatment protocols for patients with coronary artery disease and heart failure in the hospital setting.

Second, it helps to assure that all doctors responsible for treating cardiac patients – in the Emergency Department, in the Intensive/Coronary Care Unit, and in the inpatient medical-surgical units – are up to date on the very latest approaches to treatment. The educational component of GWTG is constantly updated to provide the most current information.

Third, the program measures compliance at the time care is being delivered. The software enables us to provide immediate feedback to doctors and nurses on their individual adherence to recommended treatment guidelines.

Fourth, the program emphasizes prevention of secondary events, such as another heart attack or rehospitalization for chronic heart failure.

How is being part of the GWTG national database helpful?

As part of the GWTG national database, the caregivers at Cayuga Medical Center can compare our care to other hospitals. The American Heart Association gives us feedback on how we are doing on every aspect of cardiac care, from the time a patient comes through the doors of the Emergency Department to time of discharge. Many different departments within the hospital are involved in caring for cardiac patients and GWTG helps to create a cardiac-care team across all of these individual departments.

Another benefit to participating in GWTG is the sharing of information from hospitals across the country about the best processes for improving current services and for implementing new services. This helps participating hospitals from having to reinvent the wheel and enables them to avoid methods that don’t work. Participating hospitals are also assisted by GWTG in complying with accreditation requirements for the Joint Commission on Accreditation of Healthcare Organizations (JACHO).

Additionally, Get With the Guidelines enables us to track data in many different fields. For example, we can look at cardiac care by gender and age and treatment plan. All of this helps us identify potential areas for improvement within specific cardiac patient populations.

Hospitals are very focused on performance improvement initiatives, which have the potential to improve patient care and outcomes. However, quantifiably measuring the impact of these initiatives can be difficult. GWTG is a very helpful tool in this regard. According to the American Heart Association, many more lives could be saved each year if the Get With the Guidelines program was implemented nationwide.

As we expand Cardiac Care Services at Cayuga Medical Center in the coming years, we want to ensure that the foundation upon which we build is of the highest quality. Get With the Guidelines is just one more tool to help us provide excellent cardiac care to the community we serve.

Sandy Fuller, RN, is director of Cardiac Care Services at Cayuga Medical Center. She works closely with cardiac-care medical director, cardiologist Dr. Malcolm Brand, FACC, and a team of board-certified cardiologists and experienced cardiac, emergency, and intensive care nurses.


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