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"Most patients do not get totally proper, reliable care for heart attacks, even though all these interventions, save one, are virtually cost-free."1
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Clinical Contact
Rosa M. Johnson, ARNP, MN, CPHQ
Director, Medicare Operations, Washington
Qualis Health
206-364-9700, ext. 2142
rosaj@qualishealth.org


The Six Changes
Rapid Response Teams
Prevent Adverse Drug Events
Reliable, Evidence-Based Care for Acute Myocardial Infarction
Prevent Central Line Infections
Prevent Surgical Site Infections
Prevent Ventilator-Associated Pneumonia

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Deliver Reliable, Evidence-Based Care for Acute Myocardial Infarction
… to prevent deaths from heart attack.

There is a certain set of simple things that should happen if you have a heart attack, and yet we know, and you can read it in the National Quality report that the fidelity rates for these treatments range in the 40, 50, 60 percent range. They’re nowhere near 100.1
Donald Berwick, President and CEO, Institute for Healthcare Improvement

The American College of Cardiology and the American Heart Association have issued evidence-based guidelines for the management of patients with AMI2.

Implementation of the therapies addressed by these guidelines has been shown to reduce mortality among patients with AMI. For example, prompt administration of aspirin has been shown to reduce the risk of death from vascular events by 15 percent. Beta-blockers have been shown to reduce the risk of death in the first week after AMI by 13 percent and long-term mortality by 23 percent3,4.

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References
1Berwick, Donald, Presentation to the Association of Health Care Journalists, AHCJ Sixth National Conference: A Discussion with Donald Berwick, 4/2/05. Transcript provided by kaisernetwork.org, a free service of the Kaiser Family Foundation.

2Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction–executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). J Am Coll Cardiol. 2004;44:671-719.

3Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of meta-analyses of randomized controlled trials and recommendations of clinical experts: treatments for myocardial infarction. JAMA. 1992;268:240-248.

4Hennekens CH, Albert CM, Godfried SL, Gaziano JM, Buring JE. Adjunctive drug therapy of acute myocardial infarction – evidence from clinical trials. N Engl J Med. 1996;335:1660-1667.