The five hospital factors that affect heart attack survival

Mar 15, 2011

A new Yale University study looks at why there is such a big difference in the mortality rates among patients treated for heart attacks in hospitals across the country. The study appears in the March issue of the Annals of Internal Medicine.

Until now, little has been known about the factors that may influence this variation in death rates. The Yale team reviewed 11 hospitals through interviews and site visits. Those selected were among the best and worst performers, as rated by the federal agency that administers Medicare and Medicaid.

"Previous research looked at whether characteristics like urban location, teaching status, geographical region, and socio-economic status of patients are related to acute (AMI) , but these factors don't explain much of the variation in mortality," said Leslie A. Curry, Ph.D., research scientist at the Yale Global Health Leadership Institute and lead author on the paper. "We were particularly interested in the roles of social interactions and organizational culture, which are difficult to measure using common research approaches like surveys."

Hospitals in the high- and low-performing groups differed substantially in five ways: organizational values and goals, senior management involvement, broad staff presence and expertise in AMI care, communication and coordination, and problem solving.

"Our research shows that the key facets to safety and quality in hospitals may not be new gadgets," says Elizabeth Bradley, Ph.D., faculty director at the Yale Global Health Leadership Institute, professor of public health and senior author on the paper. "The essential ingredients are not expensive. If we could implement our findings in more hospitals, we could improve quality without adding to costs."

Staff in the best hospitals reported strong communication and coordination across disciplines and departments. In low-performing hospitals, sporadic involvement of senior management was common, in part due to frequent turnover, and management did not create an environment that encouraged taking responsibility for performance problems. Curry says that achieving high performance may require long-term investment and concerted efforts to create an organizational culture that supports full engagement in quality, strong communication and coordination among groups, and capacity for problem solving and learning across the organization.

"What we found was that the best hospitals were distinguished by a combination of factors that related to how they organized and managed the care and the performance of the teams," says Harlan Krumholz, M.D., professor of medicine and cardiology at Yale School of Medicine. "This study begins to address our need to know what it takes to be an outstanding performer."

Explore further: Can YouTube save your life?

add to favorites email to friend print save as pdf

Related Stories

Using death rates to judge hospital performance 'a bad idea'

Apr 21, 2010

Mortality rates are a poor measure of the quality of hospital care and should not be a trigger for public inquiries such as the investigation at the Mid Staffordshire hospital, argue experts in a paper published in the British ...

Minorities, whites get equal care in hospitals

Mar 11, 2008

A University of Maryland study of whether people receive different quality of hospital care because of their race or ethnicity found that when whites and minorities are admitted to a hospital for the same reason, they receive ...

Recommended for you

Can YouTube save your life?

14 hours ago

Only a handful of CPR and basic life support (BLS) videos available on YouTube provide instructions which are consistent with recent health guidelines, according to a new study published in Emergency Medicine Australasia, the jo ...

Doctors frequently experience ethical dilemmas

15 hours ago

(HealthDay)—For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

AMGA: Physician turnover still high in 2013

15 hours ago

(HealthDay)—For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

Obese or overweight teens more likely to become smokers

16 hours ago

A study examining whether overweight or obese teens are at higher risk for substance abuse finds both good and bad news: weight status has no correlation with alcohol or marijuana use but is linked to regular ...

Taking preventive health care into community spaces

17 hours ago

A church. A city park. An office. These are not the typical settings for a medical checkup. But a new nationwide study by the UCLA Center for Health Policy Research shows that providing health services in ...

User comments : 0