This document discusses the design of a cross-functional team to improve care for acute myocardial infarction (AMI) patients. The team included physicians, nurses, administrators, and representatives from multiple hospital departments and community hospitals. The team created standardized processes for rapid EKG analysis, communication of results, and treatment to comply with evidence-based guidelines. They also established leadership commitment through a strategic plan focusing on quality, data monitoring, and incentive-based bonuses to drive progress on goals.
This document discusses the design of a cross-functional team to improve care for acute myocardial infarction (AMI) patients. The team included physicians, nurses, administrators, and representatives from multiple hospital departments and community hospitals. The team created standardized processes for rapid EKG analysis, communication of results, and treatment to comply with evidence-based guidelines. They also established leadership commitment through a strategic plan focusing on quality, data monitoring, and incentive-based bonuses to drive progress on goals.
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This document discusses the design of a cross-functional team to improve care for acute myocardial infarction (AMI) patients. The team included physicians, nurses, administrators, and representatives from multiple hospital departments and community hospitals. The team created standardized processes for rapid EKG analysis, communication of results, and treatment to comply with evidence-based guidelines. They also established leadership commitment through a strategic plan focusing on quality, data monitoring, and incentive-based bonuses to drive progress on goals.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online from Scribd
IHS Best of the Best Series: AMI from IHI Pursuing Perfection
“It Takes Leadership”
Design Team Make-up and Functioning
• To achieve high reliability results requires: – An investment of time and money – Commitment to the use of the best evidence – Organized approach to the design task – Cooperation among clinicians • A cross-functional team: – Physician and nursing representatives from the ED – Cardiology – Many other areas in the hospital – Administrators with responsibility across the organization
Design Team Make-up and Functioning
• Required enhanced coordination with the three community hospitals admitting to its: – Emergency department – Cath lab – Coronary intensive care unit • Addressed each micro-system through which an AMI patient must pass – Created a shared vision: reduction in acute myocardial infarction mortality • Involved physicians from the ED and Cath Lab
Design for rapid flow of care from patient arrival at ED
• Hospital EMS technicians perform 12-lead electrocardiograms (EKGs) without transport delays and send results electronically while en route to hospital • On patient arrival at ED, EKGs performed within 15 minutes of arrival • Standard communication process – Simultaneously alerts all when EKG shows ST elevation • Essential physicians and staff • ED physicians and nurses • Interventional cardiologist • Cath lab staff
Design for reliable compliance with ev-based Dx & Tx
• EMS standardized: – symptom recognition – advanced cardiac life support protocols and procedures for transport to appropriate facilities • Standardized approach to care: – history taking – acute myocardial infarction symptom recognition – medication orders, and ASA administration • Retrospective case review when care does not match the evidence – identify areas of further system improvement • “All or nothing” used to measure compliance with the evidence – Care scored 1 or 0 on whether care confirms perfectly to the evidenced-based standards Best of the Best in AMI – Pursuing Perfection “It Takes Leadership” Page 2
Leadership Commitment: • Strategic plan focuses on quality, physician partnership, • Service line, fiscal and people development • Strategic plan drives the specific goals of the executive and leadership team • Progress towards goals are monitored, annual incentive – Bonuses based on successful completion of goals • System problems are solved during the many weekly CEO-led team meetings • Outcome data is continuously shared with the staff, leadership and board of trustees • Focus of communication is organized in the “Board Calendar”
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