Expecting Success: Excellence in Cardiac Care
Del Sol Medical Center implemented new concepts in cardiac care to eliminate disparities and improve the quality of care for Heart Failure (HF) and Acute Myocardial Infarction (AMI) patients through the Robert Wood Johnson Foundation, Expecting Success: Excellence in Cardiac Care project. This was achieved by standardizing documentation, process reengineering, multidisciplinary education and improving compliance with quality indicators. We also developed the first and only outpatient Nurse Practitioner Run Heart Failure Center in the region. By bridging inpatient and outpatient care, we improved both quality of life and quality of care.
Our initial data showed a 17.7% disparity between Not-Hispanic and Hispanic HF patients receiving discharge instructions. New tools and strategies to address this included: standardization of cardiac discharge instructions, extensive physician and nursing education, and development of extensive patient education materials in English/Spanish. By 4th quarter 2006, we eliminated the disparity and have maintained that through 3rd quarter 2007. Patients who received all Measures of Ideal Care for HF increased from 15% in 4th quarter 2005 to 94% in 4th quarter 2007. Readmissions for HF within 30 days decreased from 16% in 4th quarter 2005 to 7% in 4th quarter 2007. Improving performance on the HF Measures of Ideal Care appears to correlate with the decrease in HF readmission rates. Patients who received all Measures of Ideal Care for AMI increased from 17% to 89% during the same period.
The Expecting Success project has changed the way we provide care for cardiac patients. Our QI system is one of concurrent vs. retrospective review and quality is the responsibility of everyone from our senior leadership team to frontline staff. Our goal is to ensure the best quality care for every patient, every time.