title: Impact of Society of Cardiovascular Patient Care accreditation on quality: an ACTION Registry®-Get With The Guidelines™ analysis.
abstract: BACKGROUND
  The Society of Cardiovascular Patient Care (SCPC) accredits hospital acute coronary syndrome management. The influence of accreditation on the subset of patients diagnosed with acute myocardial infarction (AMI) is unknown. Our purpose was to describe the association between SCPC accreditation and hospital quality metric performance among AMI patients enrolled in ACTION Registry-GWTG (ACTION-GWTG). This program is a voluntary registry that receives self-reported hospital AMI quality metrics data and provides quarterly feedback to 487 US hospitals.
  
  
  METHODS
  Using urban nonacademic hospital registry data from January 1, 2007, to June 30, 2010, we performed a 1 to 2 matched pairs analysis, selecting 14 of 733 (1.9%) SCPC accredited and 28 of 309 (9.1%) nonaccredited registry facilities to compare changes in quality metrics between the year before and after SCPC accreditation.
  
  
  RESULTS
  All hospitals improved quality metric compliance during the study period. Nonaccredited hospitals started with slightly lower rates of AMI composite score 1 year before accreditation. Although improvement compared with baseline was greater for nonaccredited hospitals (odds ratio = 1.27; 95% confidence interval: 1.20, 1.35) than accredited hospitals (odds ratio = 1.15; 95% confidence interval: 1.07, 1.23) (P = 0.022), the group ended with similar compliance scores (92.1% vs. 92.2%, respectively). Improvements in evaluating left ventricular function (P = 0.0001), adult smoking cessation advice (P = 0.0063), and cardiac rehab referral (P = 0.0020) were greater among nonaccredited hospitals, whereas accredited hospitals had greater improvement in discharge angiotensin-converting-enzyme inhibitor or angiotensin II receptor blocker use for left ventricular systolic dysfunction (P = 0.0238).
  
  
  CONCLUSIONS
  All hospitals had high rates of quality metric compliance and finished with similar overall AMI performance composite scores after 1 year.
authors.affiliation: Baylor College of Medicine, Ben Taub Hospital, 1504 Taub Loop, Houston, TX 77030, USA. Frankpeacock@gmail.com
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kontos
authors.forename: Ezra
authors.initials: E
authors.lastname: Amsterdam
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.forename: Deborah
authors.initials: D
authors.lastname: Diercks
authors.forename: Lee
authors.initials: L
authors.lastname: Garvey
authors.forename: Louis
authors.initials: L
authors.lastname: Graff
authors.forename: DaJuanicia
authors.initials: D
authors.lastname: Holmes
authors.forename: Kay Styer
authors.initials: KS
authors.lastname: Holmes
authors.forename: James
authors.initials: J
authors.lastname: McCord
authors.forename: Kristin
authors.initials: K
authors.lastname: Newby
authors.forename: Matthew
authors.initials: M
authors.lastname: Roe
authors.forename: Shahriar
authors.initials: S
authors.lastname: Dadkhah
authors.forename: Angela
authors.initials: A
authors.lastname: Siler-Fisher
authors.forename: Michael
authors.initials: M
authors.lastname: Ross
mesh_terms: D000068:Accreditation / Q000592:standards / Q000706:statistics & numerical data*; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D016555:Matched-Pair Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data; D012042:Registries; D016540:Smoking Cessation; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000628:therapy
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors