QUALITY INITIATIVES
Treating Heart Attacks (Myocardial Infarction)
When the blood flow in the arteries to the heart is completely blocked, part
of the heart muscle dies causing an acute myocardial infarction, commonly referred
to as a heart attack.
Research identified the following six indicators to be the key components of
performance in treating heart attacks. A comparison of Hanover Hospital Performance
to both Pennsylvania and national averages follows.
+ Quarter 3 (2007) Data
++ Quarter 2 (2007) Data
Indicator |
Hanover |
Pennsylvania (++) |
National (++) |
Significance |
Administration of aspirin within 24 hours of admission |
100% |
97% |
97% |
BETTER |
Aspirin prescribed at discharge |
100% |
97% |
97% |
BETTER |
Beta blocker within 24 hours of admission |
95.2% |
95% |
94% |
BETTER |
Beta blocker prescribed at discharge |
91.7% |
98% |
97% |
WORSE |
ACE inhibitors prescribed at discharge |
100% |
91% |
92% |
BETTER |
Smoking counseling given during hospitalization |
100% |
98% |
98% |
BETTER |
Why these indicators matter:
- Treatment with aspirin within 24 hours of admission and at discharge: Aspirin is an effective, inexpensive and safe treatment for heart attack. Aspirin therapy reduces short-term mortality in patients with suspected heart attack by 23%, although it should not be given to patients with certain conditions (e.g. hemorrhagic stroke, gastrointestinal bleeding).
- Treatment with beta blockers upon admission and at discharge:
Beta-blocker therapy can reduce post-heart attack mortality by as much as 25% by helping to reduce the workload of the heart.
- ACE Inhibitor prescribed at discharge:
ACE Inhibitors are used to treat high blood pressure and reduce the workload of the heart following a heart attack. ACE Inhibitors can significantly reduce post-heart attack mortality.
- MI: Smoking cessation advice:
Smokers with coronary artery disease who stop smoking have a better prognosis than those who keep smoking; at the time of a heart attack, smokers are most responsive to advice about quitting smoking.
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Treating Congestive Heart Failure (CHF)
Heart failure is a chronic disease that occurs when the heart muscle has been damaged
and can no longer effectively pump blood to the rest of the body.
Research identified the following indicators to be the key components of performance in
treating CHF. A comparison of Hanover Hospital performance to both Pennsylvania and
national averages follows.
+ Quarter 3 (2007) Data
++ Quarter 2 (2007) Data
Indicator |
Hanover |
Pennsylvania (++) |
National (++) |
Significance |
ACE inhibitor prescribed at discharge |
100% |
91% |
90% |
BETTER |
Evaluation of left ventricular ejection fraction (Echocardiograms) |
95.7% |
95% |
94% |
BETTER |
Smoking advice/counseling |
100% |
95% |
95% |
BETTER |
Why these indicators matter:
- ACE inhibitor prescribed at discharge:
ACE inhibitors are used to treat high blood pressure and reduce the workload of the heart in patients with congestive heart failure. As such, ACE inhibitors can significantly reduce mortality rates.
- Evaluation of left ventricular ejection fraction via echocardiogram:
Performing an echocardiogram allows practitioners to see how well the heart is contracting and pumping blood. This diagnostic information is used to drive the overall treatment of a patient.
- CHF: Smoking cessation advice:
Smokers with heart failure disease who stop smoking have a better prognosis than those who keep smoking; at the time of exacerbation, smokers are most responsive to advice about quitting smoking.
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