title: Coronary care in New York City hospitals.
abstract: New York City, with six medical schools and an elaborate emergency medical system, would appear to be a locale with optimal resources for coronary care. To assess coronary care facilities and practices, a comprehensive questionnaire was prepared by a multidisciplinary committee and submitted to 72 hospitals. Seventy-nine percent (57/72) responded, including all medical school affiliated hospitals and 41 of the 45 with more than 300 beds. Twenty-nine percent (16/55) did not have a coronary care unit separate from a general intensive care unit. Thirty-three percent (18/55) of coronary care units were designed before 1970. Although 85% (46/54) of the coronary care units had a 1:2 registered nurse per patient ratio during days, only 43% (23/54) maintained this ratio at night. Central monitoring was available in all hospitals, but only 40% (21/52) indicated 24-hour continuous monitor observation. Forty-five percent (25/55) had cardiac catheterization facilities, and 43% (24/56) had an intra-aortic balloon available. Forty-six percent (26/57) of coronary care units transferred post-myocardial infarction patients to non-monitored general beds. Fifty-eight percent (31/53) offered dietary counseling to patients, and 33% (18/54) had an inpatient cardiac rehabilitation program. Thus, New York City hospitals demonstrate a marked variability in coronary care unit facilities and practices and a substantial number of hospitals deviate from published recommendations for coronary care units.
authors.forename: M
authors.initials: M
authors.lastname: Berger
authors.forename: H S
authors.initials: HS
authors.lastname: Friedman
authors.forename: L M
authors.initials: LM
authors.lastname: Gerber
authors.forename: M
authors.initials: M
authors.lastname: Greenberg
authors.forename: B
authors.initials: B
authors.lastname: Levine
authors.forename: M B
authors.initials: MB
authors.lastname: Mirsky
authors.forename: C H
authors.initials: CH
authors.lastname: Nacht
authors.forename: C
authors.initials: C
authors.lastname: Sheppard
mesh_terms: D003325:Coronary Care Units / Q000600:supply & distribution*; D003327:Coronary Disease / Q000628:therapy; D006761:Hospitals / Q000592:standards*; D006801:Humans; D009519:New York City