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Hospital 'report cards' found not effective for quality improvement

Hospitals that were given feedback on their performance on certain quality indicators for treating heart attack patients did not show more improvement in those areas than hospitals that were provided with the feedback at a later date, according to a study in the July 20 issue of JAMA.

Acute myocardial infarction (AMI; heart attack) patients often do not receive recommended evidence-based treatments, according to background information in the article. There is increasing interest in implementing quality improvement strategies for AMI care. One quality improvement strategy that has been suggested is feedback on "quality indicators" to hospitals and clinicians treating AMI patients. Quality indicators are defined as a summary of clinical performance over a specified time. It is suggested that "report cards" presenting a summary of quality indicators relevant to care provided by individual hospitals can catalyze quality improvement at these hospitals. Ideally, hospital report cards provide clinicians with an accurate picture of the care they deliver and provide benchmarks for comparison, such as the care delivered at other hospitals or recommended target rates. Hospital report cards are increasingly being implemented in the United States and some parts of Canada as a strategy for quality improvement in many areas of health care, despite lack of strong evidence to support their use.

Christine A. Beck, M.Sc., of McGill University Health Centre, Montreal, and colleagues conducted a study to determine whether hospital report cards produced using linked administrative databases are effective for improving AMI care. The study included patients with AMI who were admitted to 76 acute care hospitals in Quebec that treated at least 30 AMI patients per year between April 1, 1999, and March 31, 2003. The hospitals were randomly assigned to receive rapid (immediate; n = 38 hospitals and 2,533 patients) or delayed (14 months; n = 38 hospitals and 3,142 patients) con
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Contact: Ian Popple
514-843-1560
JAMA and Archives Journals
19-Jul-2005


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