National quality campaigns: who benefits?
BACKGROUND
The use of national quality campaigns to foster evidence-based hospital practices is increasing. Because campaigns typically do not limit access to their resources, they may influence non-enrolled hospitals as well.


OBJECTIVE
To examine the relative impact of a national campaign, the Door-to-Balloon (D2B) Alliance, on enrolled and non-enrolled hospitals.


METHODS
In this prospective cohort study, we compared the use of D2B Alliance resources (eg, webinars, online community, mentor network), changes in the use of strategies recommended by the D2B Alliance, and perceived impact of the D2B Alliance between hospitals that enrolled in the D2B Alliance (n=264) and hospitals that declined enrolment (n=101).


RESULTS
More than half (53.2%) of non-enrolled hospitals reported using at least some of the resources made available by the D2B Alliance to improve door-to-balloon times. This compared with 83.5% of enrolled hospitals reporting that they used D2B Alliance resources (p<0.01). Both enrolled and non-enrolled hospitals significantly increased their use of recommended hospital strategies between 2005 and 2008, although the use of strategies remained incomplete (35.5-91.5% use). There was no significant difference between the use of these strategies between enrolled and non-enrolled hospitals at follow-up (p > or = 0.51), adjusted for baseline use. About half of all hospitals reported that door-to-balloon times would have been worse at their hospital without the existence of the D2B Alliance.


CONCLUSIONS
This research suggests that national quality campaigns with open access to campaign resources may have substantial spillover effects on non-enrolled hospitals.
Hansen
Luke O
LO
Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 750 N Lakeshore Drive, 11th Floor, Ste 187, Chicago, IL 60611, USA. l-hansen@northwestern.edu
Herrin
Jeph
J
Nembhard
Ingrid M
IM
Busch
Susan
S
Yuan
Christina T
CT
Krumholz
Harlan M
HM
Bradley
Elizabeth H
EH
D015331:Cohort Studies; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007373:Interinstitutional Relations; D007902:Length of Stay; D009862:Online Systems; D015397:Program Evaluation; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D013997:Time Factors; D014481:United States