According to several medical registries, there is a need to improve the care of post–myocardial
infarction (MI) patients, especially those with left ventricular dysfunction (LVD)
and heart failure. This can potentially be achieved by implementing disease management
programs, which include critical pathways, patient education, and multidisciplinary
hospital teams. Currently, algorithms for critical pathways, including discharge processes,
are lacking for post-MI LVD patients. Such schemes can increase the use of evidence-based
medicines proved to reduce mortality. Educational programs are aimed at increasing
patients' awareness of their condition, promoting medication compliance, and encouraging
the adoption of healthy behaviors; such programs have been shown to be effective in
improving outcomes of post-MI LVD patients. Reductions in all-cause hospitalizations
and medical costs as well as improved survival rates have been observed when a multidisciplinary
team (a nurse, a pharmacist, and a hospitalist) is engaged in patient care. In addition,
the use of the “pay for performance” method, which can be advantageous for patients,
physicians, and hospitals, may potentially improve the care of post-MI patients with
LVD.
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References
- The role of in-hospital initiation of cardioprotective therapies to improve treatment rates and clinical outcomes.Rev Cardiovasc Med. 2002; 3: S2-S10
- Impact of evidence-based heart failure therapy use at hospital discharge on treatment rates during follow-up: a report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) [abstract].J Am Coll Cardiol. 2005; 45: 345A
- Association between hospital process performance and outcomes among patients with acute coronary syndromes.JAMA. 2006; 295: 1912-1920
- Heterogeneity in the management and outcomes of patients with acute myocardial infarction complicated by heart failure: the National Registry of Myocardial Infarction.Circulation. 2002; 105: 2605-2610
- Adherence to heart failure quality-of-care indicators in US hospitals: analysis of the ADHERE Registry.Arch Intern Med. 2005; 165: 1469-1477
- ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction).Circulation. 2004; 110: e82-e293
- ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult.Circulation. 2005; 112: e154-e235
- Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme): an international survey.Lancet. 2002; 360: 1631-1639
- Risk-treatment mismatch in the pharmacotherapy of heart failure.JAMA. 2005; 294: 1240-1247
- Implantable cardioverter defibrillator utilization based on discharge diagnoses from Medicare and managed care patients.J Cardiovasc Electrophysiol. 2002; 13: 38-43
- Predictors and determinants of hospital length of stay in congestive heart failure in ten community hospitals.J Heart Lung Transplant. 1997; 16: 548-555
- Improving quality of care for acute myocardial infarction: the Guidelines Applied in Practice (GAP) Initiative.JAMA. 2002; 287: 1269-1276
- Rationale and design of the Cardiac Hospitalization Atherosclerosis Management Program at the University of California Los Angeles.Am J Cardiol. 2000; 85: 10A-17A
- Improved treatment of coronary heart disease by implementation of a Cardiac Hospitalization Atherosclerosis Management Program (CHAMP).Am J Cardiol. 2001; 87: 819-822
- Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design.Am Heart J. 2004; 148: 43-51
- Association between performance measures and clinical outcomes for patients hospitalized with heart failure.JAMA. 2007; 297: 61-70
- Integrating “best of care” protocols into clinicians' workflow via care provider order entry: impact on quality-of-care indicators for acute myocardial infarction.J Am Med Inform Assoc. 2006; 13: 188-196
- Get with the Guidelines improves cardiovascular care in hospitalized patients with CAD [abstract].Circulation. 2003; 108: 722
- Critical Pathways in Cardiology.in: Lippincott Williams & Wilkins, Philadelphia2001: 131-141
- Outpatient adherence to beta-blocker therapy after acute myocardial infarction.J Am Coll Cardiol. 2002; 40: 1589-1595
- Adherence to evidence-based therapies after discharge for acute coronary syndromes: an ongoing prospective, observational study.Am J Med. 2004; 117: 73-81
- Transition of care for hospitalized elderly patients—development of a discharge checklist for hospitalists.J Hosp Med. 2006; 1: 354-360
Joint Commission on Accreditation of Healthcare Organizations. Specifications Manual for National Hospital Quality Measures: Version 2.4. Available at: http://www.jointcommission.org/PerformanceMeasurement/PerformanceMeasurement/Current+NHQM+Manual.htm. Accessed July 15, 2008
- Effect of discharge instructions on readmission of hospitalised patients with heart failure: do all of the Joint Commission on Accreditation of Healthcare Organizations heart failure core measures reflect better care?.Qual Saf Health Care. 2006; 15: 414-417
- Improved compliance with quality measures at hospital discharge with a computerized physician order entry system.Am Heart J. 2006; 151: 643-653
- Discharge education improves clinical outcomes in patients with chronic heart failure.Circulation. 2005; 111: 179-185
- Cost effective management programme for heart failure reduces hospitalisation.Heart. 1998; 80: 442-446
- Randomized trial of an education and support intervention to prevent readmission of patients with heart failure.J Am Coll Cardiol. 2002; 39: 83-89
- A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention.Arch Phys Med Rehabil. 2004; 85: 1915-1922
- The influence of risk status on guideline adherence for patients with non–ST-segment elevation acute coronary syndromes.Am Heart J. 2006; 151: 1205-1213
- Cardiac rehabilitation after myocardial infarction in the community.J Am Coll Cardiol. 2004; 44: 988-996
- Clinical characteristics, process of care, and outcomes of Hispanic patients presenting with non-ST-segment elevation acute coronary syndromes: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines (CRUSADE).Am Heart J. 2006; 152: 110-117
- Ring in the New Year with care delivery based on pay-for-performance.Prog Cardiovasc Nurs. 2006; 21: 55-56
- Improving outcomes in heart failure: it's not unusual beyond usual care.Circulation. 2002; 105: 2810-2812
- Meta-analysis and review of heart failure disease management randomized controlled clinical trials.Am Heart J. 2005; 149: 722-729
- Pilot study to determine the impact of a multidisciplinary educational intervention in patients hospitalized with heart failure.Am Heart J. 2005; 150: 982.e1-982.e9
- Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial.CMAJ. 2005; 173: 40-45
- Effectiveness of comprehensive disease management programmes in improving clinical outcomes in heart failure patients: a meta-analysis.Eur J Heart Fail. 2005; 7: 1133-1144
- Benefits of comprehensive inpatient education and discharge planning combined with outpatient support in elderly patients with congestive heart failure.Congest Heart Fail. 2005; 11: 315-321
- A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure.N Engl J Med. 1995; 333: 1190-1195
- National surveillance of emergency department visits for outpatient adverse drug events.JAMA. 2006; 296: 1858-1866
- Pharmacist participation on physician rounds and adverse drug events in the intensive care unit.JAMA. 1999; 282: 267-270
- Medication errors in hospitalized cardiovascular patients.Arch Intern Med. 2003; 163: 1461-1466
- Pharmacist interventions to improve the management of coronary artery disease.Am J Health Syst Pharm. 2004; 61: 2672-2678
- Effect of a pharmacist-led intervention on diuretic compliance in heart failure patients: a randomized controlled study.J Card Fail. 2003; 9: 404-411
- The hospitalist.Radiol Manage. 2000; 22: 57-60
- The role of hospitalists in the management of acute decompensated heart failure.Am Heart Hosp J. 2005; 3: 111-117
- Associations with reduced length of stay and costs on an academic hospitalist service.Am J Manag Care. 2004; 10: 561-568
- Improving the management of patients after myocardial infarction, from admission to discharge.Clin Ther. 2006; 28: 1509-1539
- Public reporting and pay for performance in hospital quality improvement.N Engl J Med. 2007; 356: 486-496
- Pay for performance at the tipping point.N Engl J Med. 2007; 356: 515-517
- Relationship between Medicare's hospital compare performance measures and mortality rates.JAMA. 2006; 296: 2694-2702
- Core competencies in hospital medicine: development and methodology.J Hosp Med. 2006; 1: 48-56
- How to use the core competencies in hospital medicine: a framework for curriculum development.J Hosp Med. 2006; 1: 57-67
- Health-care process improvement decisions: a systems perspective.Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006; 19: 93-104
- A qualitative study of increasing beta-blocker use after myocardial infarction: why do some hospitals succeed?.JAMA. 2001; 285: 2604-2611
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© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
