المؤلفون: Bradley, Elizabeth H., Herrin, Jeph, Mattera, Jennifer A., Holmboe, Eric S., Wang, Yongfei, Frederick, Paul, Roumanis, Sarah A., Radford, Martha J., Krumholz, Harlan M.

المصدر: Medical Care, 2005 Mar 01. 43(3), 282-292.

الوصول الحر: https://www.jstor.org/stable/3768227Test

المؤلفون: Bradley, Elizabeth H., Herrin, Jeph, Mattera, Jennifer A., Holmboe, Eric S., Wang, Yongfei, Frederick, Paul, Roumanis, Sarah A., Radford, Martha J., Krumholz, Harlan M.

المصدر: Medical Care, 2004 Jun 01. 42(6), 591-599.

الوصول الحر: https://www.jstor.org/stable/4640791Test

المؤلفون: Marciniak, Thomas A., Ellerbeck, Edward F., Radford, Martha J., Kresowik, Timothy F., Gold, Jay A., Krumholz, Harlan M., Kiefe, Catarina I., Allman, Richard M., Vogel, Robert A., Jencks, Stephen F.

المساهمون: Department of Quantitative Health Sciences

المصدر: JAMA : the journal of the American Medical Association ; 279 ; 17 ; 1351-7

مصطلحات موضوعية: Alabama, Cardiology, Cardiology Service, Hospital, Connecticut, Data Collection, Hospital Mortality, Hospitals, Humans, Iowa, Medicare, Myocardial Infarction, Pilot Projects, Professional Review Organizations, Quality Assurance, Health Care, Quality Indicators, Statistics, Nonparametric, Survival Analysis, United States, Wisconsin, Bioinformatics, Biostatistics, Epidemiology, Health Services Research

الوصف: CONTEXT: Medicare has a legislative mandate for quality assurance, but the effectiveness of its population-based quality improvement programs has been difficult to establish. OBJECTIVE: To improve the quality of care for Medicare patients with acute myocardial infarction. DESIGN: Quality improvement project with baseline measurement, feedback, remeasurement, and comparison samples. SETTING: All acute care hospitals in the United States. PATIENTS: Preintervention and postintervention samples included all Medicare patients in Alabama, Connecticut, Iowa, and Wisconsin discharged with principal diagnoses of acute myocardial infarctions during 2 periods, June 1992 through December 1992 and August 1995 through November 1995. Indicator comparisons were made with a random sample of Medicare patients in the rest of the nation discharged with acute myocardial infarctions from August 1995 through November 1995. Mortality comparisons involved all Medicare patients nationwide with inpatient claims for acute myocardial infarctions during 2 periods, June 1992 through May 1993 and August 1995 through July 1996. INTERVENTION: Data feedback by peer review organizations. MAIN OUTCOME MEASURES: Quality indicators derived from clinical practice guidelines, length of stay, and mortality. RESULTS: Performance on all quality indicators improved significantly in the 4 pilot states. Administration of aspirin during hospitalization in patients without contraindications improved from 84% to 90% (P< .001), and prescription of beta-blockers at discharge improved from 47% to 68% (P < .001). Mortality at 30 days decreased from 18.9% to 17.1% (P = .005) and at 1 year from 32.3% to 29.6% (P < .001). These improvements in quality occurred during a period when median length of stay decreased from 8 days to 6 days. Performance on all quality indicators except reperfusion was better in the pilot states than in the rest of the nation in 1995, and the differences were statistically significant for aspirin use at discharge (P < .001), ...

العلاقة: Link to Article in PubMed; http://jama.ama-assn.org/cgi/content/abstract/279/17/1351Test; JAMA. 1998 May 6;279(17):1351-7.; 0098-7484 (Linking); 9582042; http://hdl.handle.net/20.500.14038/46940Test; https://escholarship.umassmed.edu/qhs_pp/142Test; 1287887; qhs_pp/142

الإتاحة: https://doi.org/20.500.14038/46940Test
https://hdl.handle.net/20.500.14038/46940Test
https://escholarship.umassmed.edu/qhs_pp/142Test

المؤلفون: Chen, Jersey, Radford, Martha J.

المصدر: Health Affairs. Jul/Aug1999, Vol. 18 Issue 4, p53. 16p. 5 Charts.

مصطلحات موضوعية: *HOSPITALS, *MEDICARE, MYOCARDIAL infarction treatment

مصطلحات جغرافية: UNITED States

مستخلص: Examines whether Medicare patients with acute myocardial infarction admitted to one of HCI-Mercer's `100 top hospitals' in the United States had better outcomes than patients treated in other hospitals. Suitability of the top 100 list for identifying hospitals with higher financial measures; Lack of evidence that the quality of care was sacrificed for the sake of efficiency.

المؤلفون: Radford, Martha J.¹ martha.radford@nyumc.org

المصدر: Journal of the American College of Cardiology (JACC). Mar2016, Vol. 67 Issue 8, p973-975. 3p.

مصطلحات موضوعية: *HEART failure, *PATIENT readmissions, *HEALTH policy, *MEDICAL care, *MYOCARDIAL infarction, *PNEUMONIA, *DIAGNOSIS, *HEART failure treatment, *MYOCARDIAL infarction treatment, *PNEUMONIA treatment, *INSURANCE statistics, *HOSPITALS, *MEDICARE

المؤلفون: Holmboe, Eric S., Meehan, Thomas P., Radford, Martha J., Wang, Yun, Krumholz, Harlan M., Holmboe, E S, Meehan, T P, Radford, M J, Wang, Y, Krumholz, H M

المصدر: American Journal of Medical Quality; May/Jun2000, Vol. 15 Issue 3, p106-113, 8p

مصطلحات موضوعية: MYOCARDIAL infarction-related mortality, MYOCARDIAL infarction treatment, COMPARATIVE studies, HOSPITALS, RESEARCH methodology, MEDICAL cooperation, ORGANIZATIONAL change, PROFESSIONAL standards review organizations (Medicine), QUALITY assurance, RESEARCH, RESEARCH funding, EVALUATION research, EVALUATION of human services programs

مصطلحات جغرافية: CONNECTICUT

مستخلص: The objective of this study was to investigate what happened to improve the quality of care for acute myocardial infarction (AMI) at all 32 nonfederal hospitals in Connecticut and to assess the impact of the Cooperative Cardiovascular Project (CCP) on quality improvement (QI) activities for AMI. We performed a questionnaire study with secondary analyses using the CCP database. On-site interviews were conducted with QI directors at all 32 Connecticut nonfederal hospitals that participated in the Health Care Financing Administration's Cooperative Cardiovascular Project (CCP) in 1992-93 and 1995. The interviews sought information about the makeup of QI departments, specific approaches used to improve the care of patients with AMI, and the perceived value of the CCP to each individual hospital. Results showed that the number of full-time equivalents (FTEs) and FTEs per beds employed in QI departments ranged from 1 to 30 and from 0.4 to 7.9, respectively, with a registered nurse most often serving as the department head (27/32). Over half of the departments (17/32) had additional responsibilities. The majority (25/32) used some combination of physician champions, multidisciplinary QI teams, standing orders, or critical pathways to effect change in AMI care. Finally, 26 of the 32 hospitals believed the CCP was valuable because it provided credible benchmark data, a catalyst for change, or a specific focus on processes of care needing improvement in AMI. Despite great variability in institutional resources, all 32 hospitals used a similar combination of QI approaches to effect change in AMI care. However, there is variable scientific evidence supporting these approaches. Externally sponsored projects such as the CCP appear to play a useful role for individual hospitals. Defining the optimal methods of QI is difficult given that hospitals are using complex combinations of nonstandardized improvement interventions. [ABSTRACT FROM AUTHOR]

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المؤلفون: Chen, Jersey, Krumholz, Harlan M., Radford, Martha J.

المصدر: New England Journal of Medicine. 06/24/99, Vol. 340 Issue 25, p2006-2007. 1p.

مصطلحات موضوعية: *LETTERS to the editor, *HOSPITALS

مستخلص: A letter to the editor is presented in response to the article "Do America's Best Hospitals Perform Better for Myocardial Infarction?," from the January 28, 1999 issue.