Quality improvement at the national level. Lessons from the Cooperative Cardiovascular Project.
Most quality improvement projects address care delivered in one service of a hospital, such as the operating suite or the obstetrics service. Some projects are collaborative efforts involving groups of hospitals with similar interests. Few projects attempt to change care on a population basis (i.e., involving all providers in entire states or the nation as a whole.) The Cooperative Cardiovascular Project (CCP), sponsored by the Health Care Financing Administration, is attempting to improve care for all Medicare patients suffering from acute myocardial infarctions nation-wide. The CCP has been active since 1993 and, in a pilot project, has demonstrated that care can be improved on a population basis (i.e., in four entire states). This article explores the lessons learned from the CCP pilot and from the evolving CCP national experience.
Marciniak
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Health Care Financing Administration, USA.
Mosedale
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Ellerbeck
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D014487:Centers for Medicare and Medicaid Services, U.S.; D019317:Evidence-Based Medicine; D006801:Humans; D006278:Medicare; D009203:Myocardial Infarction / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011366:Professional Review Organizations; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D014481:United States