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Interorganizational Collaboration in Emergency Cardiovascular Care

Langabeer, James R. II PhD; Champagne-Langabeer, Tiffany PhD; Helton, Jeffrey R. PhD; Segrest, Wendy MS; Kash, Bita PhD; DelliFraine, Jami PhD; Fowler, Raymond MD

Quality Management in Healthcare: January/March 2017 - Volume 26 - Issue 1 - p 1–6
doi: 10.1097/QMH.0000000000000120
Original Articles

Background: Interorganizational collaboration management theory contends that cooperation between distinct but related organizations can yield innovation and competitive advantage to the participating organization. Yet, it is unclear if a multi-institutional collaborative can improve quality outcomes across communities.

Methods: We developed a large regional collaborative network of 15 hospitals and 24 emergency medical service agencies surrounding Dallas, Texas, and collected patient-level data on treatment times for acute myocardial infarctions. Using a pre-/posttest research design, we applied median tests of differences to explore outcome changes between groups and over the 6-year period, using data extracted from participating hospital electronic health records.

Results: We analyzed temporal trends and changes in treatment times for 2302 patients with ST-elevation myocardial infarction between the pre- and posttest groups. We found a statistically significant 19-minute median reduction in the key outcome metric (total ischemic time, the time difference between the patient's first reported symptoms and the definitive opening of the artery). This represents a 10.8% community-wide improvement over time.

Conclusions: Interorganizational collaboration focused on quality improvement can impact population health across a community. This study provides a basis for broader understanding and participation by health care organizations in multi-institutional community change efforts.

School of Biomedical Informatics, The University of Texas Health Science Center, Houston (Drs Langabeer and Champagne-Langabeer); Metropolitan State University of Denver, Denver, Colorado (Dr Helton); American Heart Association, Denver, Colorado (Ms Segrest); Texas A&M University School of Public Health, College Station (Dr Kash); Department of Healthcare Leadership & Management, Medical University of South Carolina, Charleston (Dr DelliFraine); and The University of Texas Southwestern Medical Center, Dallas (Dr Fowler).

Correspondence: James R. Langabeer II, PhD, School of Biomedical Informatics, The University of Texas Health Science Center, 7000 Fannin St, Ste 600, Houston, TX 77030 (

The authors declare no conflicts of interest.

© 2017Wolters Kluwer Health | Lippincott Williams & Wilkins