Background: The Society of Cardiovascular Patient Care (SCPC) accredits hospital acute coronary syndrome management. The influence of accreditation on the subset of patients diagnosed with acute myocardial infarction (AMI) is unknown. Our purpose was to describe the association between SCPC accreditation and hospital quality metric performance among AMI patients enrolled in ACTION Registry–GWTG (ACTION–GWTG). This program is a voluntary registry that receives self-reported hospital AMI quality metrics data and provides quarterly feedback to 487 US hospitals.
Methods: Using urban nonacademic hospital registry data from January 1, 2007, to June 30, 2010, we performed a 1 to 2 matched pairs analysis, selecting 14 of 733 (1.9%) SCPC accredited and 28 of 309 (9.1%) nonaccredited registry facilities to compare changes in quality metrics between the year before and after SCPC accreditation.
Results: All hospitals improved quality metric compliance during the study period. Nonaccredited hospitals started with slightly lower rates of AMI composite score 1 year before accreditation. Although improvement compared with baseline was greater for nonaccredited hospitals (odds ratio = 1.27; 95% confidence interval: 1.20, 1.35) than accredited hospitals (odds ratio = 1.15; 95% confidence interval: 1.07, 1.23) (P = 0.022), the group ended with similar compliance scores (92.1% vs. 92.2%, respectively). Improvements in evaluating left ventricular function (P = 0.0001), adult smoking cessation advice (P = 0.0063), and cardiac rehab referral (P = 0.0020) were greater among nonaccredited hospitals, whereas accredited hospitals had greater improvement in discharge angiotensin-converting-enzyme inhibitor or angiotensin II receptor blocker use for left ventricular systolic dysfunction (P = 0.0238).
Conclusions: All hospitals had high rates of quality metric compliance and finished with similar overall AMI performance composite scores after 1 year.
From the *Baylor College of Medicine, Houston, TX; †Virginia Commonwealth University, Richmond, VA; ‡University of California (Davis) Medical Center and School of Medicine, Sacramento, CA; §Harvard Medical School and Brigham and Women’s Hospital, Boston, MA; ¶University of California, Davis, CA; ‖Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC; **University of Connecticut School of Medicine, Farmington, and The Hospital of Central Connecticut, New Britain, CT; ††Duke University School of Medicine, Durham, NC; ‡‡Society of Cardiovascular Patient care, Columbus, OH; §§Henry Ford Hospital, Detroit, MI;¶¶University of Illinois, Chicago, IL; and ‖‖Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
This research was supported by the American College of Cardiology Foundation’s National Cardiovascular Data Registry. The views expressed in this article represent those of the author(s), and do not necessarily represent the official views of the NCDR or its associated professional societies identified at www.ncdr.com. ACTION Registry–GWTG is an initiative of the American College of Cardiology Foundation and the American Heart Association, with partnering support from the Society of Chest Pain Centers, the American College of Emergency Physicians, and the Society of Hospital Medicine.
W.F.P. has board membership with Society of Cardiovascular Patient Care and receives money from them at the current time. M.C.K. has unfunded board membership with Society of Cardiovascular Patient Care and does not receive money from them at the current time. E.A. has board membership with Society of Cardiovascular Patient Care and receives payment for lectures including service on speaker’s bureaus. C.P.C. receives money from Merck for board membership; receives money for consultancy from BMS/Pfizer(ongoing and the funds are donated to charity), money received from Alnylam in the past and funds donated to charity and money received currently from CSL Behring; money currently paid to author’s institution for following grants: Accumetrics, AstraZeneca, and Takeda; money currently paid to self for following grants: Essentialis, GSK, Merck, and Sanofi/REGENERON; money paid from Automedics (C.P.C. holds stock in this company but was not paid stock from them); and travel accommodations from Merck (C.P.C. not paid by Merck for these activities). D.D. has board membership with Society of Cardiovascular Patient Care and receives money from them at the current time. L.G. has board membership with Society of Cardiovascular Patient Care and receives money from them at the current time and receives money from Philips Healthcare for consulting for them. L.G.IV has board membership with Society of Cardiovascular Patient Care and receives money from them at the current time for board travel. D.H. receives money from Duke Clinical Research Institute (DCRI) for review activities like data and statistical analysis and for writing article. He also receives employment money from DCRI. K.S.H. receives employment money from the Society of Cardiovascular Patient care. J.M. has board membership with Society of Cardiovascular Patient Care and receives money from them at the current time. K.N. has board membership with Society of Cardiovascular Patient Care as she is currently President of the society. For list of consultation and grants pending please see copy right transfer form. K.N. also receives payments for lectures as speaker from DCRI Learn and payment from Duke Clinical Medicine Series for development of educational presentation and is also senior associate editor of the journal of American Heart Association and receives money from them at the current time. M.R. receives payment for board membership from Bristol Myers Squib, Eli Lilly and Company, GlaxoSmithKline, Astra Zeneca, Kai Pharmaceuticals, Merck and Co., Janssen Pharmaceuticals, Sanofis-Aventis, Daiichi-Sankyo and Regeneron. S.D. had board membership with Society of Cardiovascular Patient Care and receives money from them in the past. He also receives employment money from Concentra and payment for lectures from Janssen forest. M.R. was board President for Society of Chest Pain and was paid stipend from them for work and time in the past. A.S.-F. has nothing to declare.
Reprints: W. Frank Peacock, MD, Emergency Medicine Research Director, Baylor College of Medicine, Ben Taub Hospital, 1504 Taub Loop, Houston, TX 77030. E-mail: Frankpeacock@gmail.com.