title: Gender disparity in emergency department non-ST elevation myocardial infarction management.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania 18103, USA.
authors.forename: Marna Rayl
authors.initials: MR
authors.lastname: Greenberg
authors.forename: William F
authors.initials: WF
authors.lastname: Bond
authors.forename: Richard S
authors.initials: RS
authors.lastname: MacKenzie
authors.forename: Rezarta
authors.initials: R
authors.lastname: Lloyd
authors.forename: Monisha
authors.initials: M
authors.lastname: Bindra
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Rupp
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Crown
authors.forename: James F
authors.initials: JF
authors.lastname: Reed
mesh_terms: 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