East Alabama Medical Center Reduces Mortality from Heart Attacks from 7.9 to 4.5 Percent

This story originally appeared in IHI's 2007 Annual Progress Report.
The dramatic part of heart attack care is the rush to get the patient from the Emergency Department (ED) into the cath lab as quickly as possible. The other elements of good acute myocardial infarction (AMI) care happen behind the scenes, but they are no less important.
At East Alabama Medical Center in Opelika, Alabama, all aspects of AMI care receive careful attention, says Laura Bell, MS, RN, CPHQ, Director of Clinical Effectiveness. “AMI care is multifaceted,” she says. “To make improvements toward perfect care you really have to pay close attention to everything.” That means working to decrease the treatment time, but also to assure that patients get aspirin and beta blockers soon after diagnosis and again at discharge, other medications at discharge if appropriate, and smoking cessation counseling if needed.
Incentives to provide perfect AMI care are built into the compensation program for front-line staff. “Many departmental goals are related to achieving big clinical initiatives, and employees can get quality bonuses when those goals are met,” says Bell. For AMI care, the goals cross departments and functions. “The bonus for ED and cath lab staff is based in part on timely care and in part on administration of beta blockers and aspirin. That way everyone is focused on perfect care, not just the part that happens in their area.”
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