title: Rapid-cycle improvement in quality of care for patients hospitalized with acute myocardial infarction or heart failure: moving from a culture of missed opportunity to a system of accountability.
abstract: We describe a 1-year multidisciplinary initiative to improve the quality of care for patients with acute myocardial infarction and heart failure. In January 2002, this rapid-cycle improvement project began with a partnership of inpatient cardiology nursing and physician leadership. This inpatient leadership team analyzed clinical and operational processes, and revised and developed tools such as standard order sets, discharge instructions, clinical pocket guides, and daily monitoring logs. Once the tools and processes, were implemented, the team began "daily monitoring" to assess tool use. At the same time, a process was implemented to provide rapid feedback on key quality indicator compliance within a short time after discharge. At 12 months, quality improvements have been demonstrated.
authors.affiliation: The University of Michigan Health System, Ann Arbor, MI 48109, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Nolan
authors.forename: Sharon
authors.initials: S
authors.lastname: VanRiper
authors.forename: AkkeNeel
authors.initials: A
authors.lastname: Talsma
authors.forename: Lance
authors.initials: L
authors.lastname: Mageno
authors.forename: Anne
authors.initials: A
authors.lastname: Richter
authors.forename: Gwen
authors.initials: G
authors.lastname: Kearly
authors.forename: Cathy
authors.initials: C
authors.lastname: Kendrick
authors.forename: Scherolyn
authors.initials: S
authors.lastname: Leggett
authors.forename: Jan
authors.initials: J
authors.lastname: Crissey
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsai
authors.forename: Gwen
authors.initials: G
authors.lastname: Blackford
authors.forename: Jean
authors.initials: J
authors.lastname: Shlafer
authors.forename: Cecelia
authors.initials: C
authors.lastname: Montoye
authors.forename: Rajendra
authors.initials: R
authors.lastname: Mehta
authors.forename: Todd
authors.initials: T
authors.lastname: Koelling
authors.forename: Robert
authors.initials: R
authors.lastname: Cody
authors.forename: Kim
authors.initials: K
authors.lastname: Eagle
mesh_terms: D006760:Hospitalization; D006801:Humans; D007857:Leadership; D009203:Myocardial Infarction; D015279:Organizational Culture; D010348:Patient Care Team; D011787:Quality of Health Care; D012941:Social Responsibility; D014481:United States