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'Secrets' of successful hospitals revealed

clinicians but a property of more ideally designed systems in which individuals work," Dr. Bradley added.

However, Dr. Krumholz noted that many ambulance crews do not have the equipment or training to perform ECGs in the field. He said this study shows investing in pre-hospital ECG capabilities would improve performance.

Christopher B. Granger, M.D., F.A.C.C., from the Duke University Medical Center, who was not connected with this study, said that it provides important new information. While clinical trials show what things should be done, and clinical practice registries reveal gaps between that ideal practice and what's actually happening in hospitals, this study addresses the critical practical issue of how practice can be improved.

"We don't have much information on how we can improve; and this study begins to bridge that gap by systematically describing what aspects of the approach hospitals take seems to be related to better performance," Dr. Granger said.

W. Douglas Weaver, M.D. from the Henry Ford Heart & Vascular Institute in Detroit, Michigan, who also was not part of this research team, said the study affirms what was known about how to reduce treatment times.

"It takes teamwork to achieve the best results, a collaboration between emergency services, paramedics and cardiologists and catheterization lab personnel. I'd also say that the value of a pre-hospital ECG is that 'a picture is worth a thousand words.' When medics and doctors see diagnostic ST segment elevation; they become focused on the problem and things happen quickly," Dr. Weaver said.


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Contact: Amy Murphy
amurphy@acc.org
301-581-3476
American College of Cardiology
28-Sep-2005


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