Yale University researchers have identified five strategies that, when used together, can reduce a hospital's mortality rate for myocardial infarctions (MIs) by more than 1%.
Although 30-day MI mortality rates have decreased nationwide, "substantial variation" remains from hospital to hospital. In an effort to understand that variation, researchers surveyed 537 U.S. hospitals on the strategies they employ to prevent MI deaths. They then compared the survey findings to CMS patient data.
Simple strategies with measurable impact
Writing in the Annals of Internal Medicine, the researchers identified five strategies associated with significant reductions in mortality:
- Encouraging teamwork between nurses and physicians, which was associated with a 0.88% decrease in MI mortality;
- Encouraging creative problem-solving among physicians, which was associated with a 0.84% decrease in MI mortality rates;
- Holding monthly meetings with clinicians and emergency transport personnel to review cases, which was associated with a 0.70% decrease in MI mortality rates;
- Maintaining a cardiologist on site at all times, which was associated with a 0.54% decrease in MI mortality rates; and
- Avoiding cross-training ICU nurses for the cardiac catheterization lab, which was associated with a 0.44% decrease in mortality rates.
The researchers found that the 15 hospitals that employed none of the five strategies had an average 30-day MI mortality rate of 15.9%. In comparison, the six hospitals that employed all five strategies had an average rate of 14.3%.
Currently, less than 7% of U.S. hospitals employ four or more of the strategies, the researchers note. "If we could implement all these strategies across the nation, we could save thousands of lives annually," says lead researcher Elizabeth Bradley. She notes that the most of strategies are "relatively inexpensive and do not require a lot of capital investment" (Smith, MedPage Today, 4/30; Reinberg, HealthDay, 4/30).