In fact, 26 percent fewer patients died in the first year after their heart attack when hospitals used quality-improvement tactics to prevent crucial heart-care steps from "slipping through the cracks" -- in much the same way a car company ensures that a car is made well before it leaves the factory.

The steps included a checklist that doctors, nurses and patients in 33 Michigan hospitals had to complete before each patient could leave the hospital. The checklist, based on national heart-care guidelines, helped make sure that patients got crucial drugs, tests and lifestyle advice that could help prevent another heart attack.

And that's what appears to have saved the lives of many patients, compared with those treated before the quality-improvement effort started. The study involved 2,857 patients, 1,489 of whom were treated after the effort started.

In general, the chance that a patient would die within a month or a year of going home from the hospital was 21 percent to 26 percent lower after the quality-improvement effort.

The findings, published in the October issue of the Journal of the American College of Cardiology, come from a study led by University of Michigan Cardiovascular Center co-director Kim Eagle, M.D., FACC and sponsored by the American College of Cardiology as part of their Guidelines Applied in Practice (GAP) initiative.

Eagle and his colleagues aren't suggesting that hospitals should become factories or treat every heart patient the same. But they point to their findings as an example of how health care professionals can learn from the quality movement that has transformed manufacturing, and how patients can benefit.

"Medicine based on memory alone is unreliable," Eagle says. "Guidelines for care, when embedded into a system used by doctor
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
28-Sep-2005