Gender disparity in emergency department non-ST elevation myocardial infarction management.
BACKGROUND
Many studies have looked at differences between men and women with acute coronary syndrome. These studies demonstrate that women have worse outcomes, receive fewer invasive interventions, and experience delay in the initiation of established medical therapies.


OBJECTIVE
Using innovative technology, we set out to unveil and resolve any gender disparities in the evaluation and treatment of patients presenting with a positive troponin while in the emergency department. Our goal was to assess the feasibility of using a business management query system to create an automated data report that could identify deficiencies in standards of care and be used to improve the quality of treatment we provide our patients.


METHODS
Over a 12-month period, key markers for patients with non-ST elevation myocardial infarction (NSTEMI) were tracked (e.g., time to electrocardiogram, door to medications). During this time, educational endeavors were initiated utilizing McKesson's Horizon Business Insight™ (McKesson Information Solutions, Alpharetta, GA) to illustrate gender differences in standard therapy. Subsequently, indicators were evaluated for improvement.


RESULTS
Substantial improvements in key indicators for management of NSTEMI were obtained and gender differences minimized where education was provided.


CONCLUSIONS
The integration of these information systems allowed us to create a successful performance improvement tool and, as an added benefit, nearly eliminated the need for manual retrospective chart reviews.
Greenberg
Marna Rayl
MR
Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania 18103, USA.
Bond
William F
WF
MacKenzie
Richard S
RS
Lloyd
Rezarta
R
Bindra
Monisha
M
Rupp
Valerie A
VA
Crown
Anne-Marie
AM
Reed
James F
JF
D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D011785:Quality Assurance, Health Care / Q000379:methods; D012737:Sex Factors