Use of discharge-worksheet enhances compliance with evidence-based myocardial infarction care.
BACKGROUND
Prior studies demonstrate that effective secondary prevention therapies are underutilized in patients with myocardial infarction (MI) at hospital discharge. At a US tertiary center, we developed and encouraged providers to complete a simple "Acute MI Discharge Worksheet" (MIDW) designed to educate patients, prompt caregivers, and provide chart documentation regarding evidence-based therapies post-MI.


RESULTS
The MIDW was introduced in May of 2000 with use encouraged in all surviving patients with MI. We calculated a patient discharge score by summing the number of quality indicators (aspirin use, beta-blocker use, ACE-inhibitor use, smoking cessation, lipid-lowering therapy, cardiac rehabilitation referral) and compared documentation of quality indicators at discharge between patients without (Group I, n = 65) and with (Group II, n = 60) the MIDW. Group II was subdivided into those with an incomplete worksheet (Group IIa, n = 26), and those with a completed worksheet (Group IIb, n = 34). Greater documentation of secondary prevention indicators occurred in patients with incomplete and completed discharge forms present. Mean Discharge scores were significantly higher for Group II vs. Group I (4.98 vs. 3.88, p < 0.0001), and Group IIb vs. Group IIa, (5.47 vs. 4.35, p < 0.001).


CONCLUSIONS
A simple "Acute MI Discharge Worksheet" was associated with better adherence and documentation of evidence-based post MI care and be a useful component to improve post MI care.
Nori
David
D
Henry Ford Hospital Department of Internal Medicine, Detroit, MI 48202, USA.
Johnson
Jeff
J
Kapke
Alissa
A
Lenk
Diane
D
Borzak
Steven
S
Hudson
Michael
M
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019317:Evidence-Based Medicine / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies