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Related Experiment Videos

What are hospitals doing to increase beta-blocker use?

Elizabeth H Bradley1, Eric S Holmboe, Yongfei Wang

  • 1Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut, USA.

Joint Commission Journal on Quality and Safety
|September 5, 2003
PubMed
Summary

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Hospitals vary widely in quality improvement strategies for beta-blocker use post-myocardial infarction. Performance reporting is common, but effectiveness perceptions differ significantly across interventions.

Area of Science:

  • Cardiology
  • Health Services Research
  • Quality Improvement

Background:

  • Limited understanding of current quality improvement (QI) practices for beta-blocker use in US hospitals.
  • Need to assess the real-world application and perceived effectiveness of various QI interventions.

Purpose of the Study:

  • To examine the prevalence of QI interventions aimed at increasing beta-blocker use after acute myocardial infarction (AMI).
  • To evaluate the perceived effectiveness of these interventions by hospital quality improvement staff.

Main Methods:

  • Descriptive, cross-sectional analysis of data from a telephone survey.
  • Survey conducted with quality improvement staff in 234 hospitals within the National Registry of Myocardial Infarction.

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Main Results:

  • Hospitals implemented an average of 5.0 QI interventions for beta-blocker use.
  • Performance reporting was most common (87.9%), but physician-specific reporting was low (26.7%).
  • Clinical pathways, standing orders, and care coordinators were frequently used; care coordinators and computer systems were rated most effective.

Conclusions:

  • Significant variation exists in the types of QI efforts implemented to enhance beta-blocker prescribing.
  • Perceived effectiveness of QI interventions for beta-blocker use varies considerably among hospitals.