title: Innovation in Data Abstraction, Education, and Consistent Application of Best Practice Guidelines: Experience and Real-World Results from a University Hospital in a Cost-Centric Environment.
abstract: BACKGROUND
  Adhering to core measures and consistent application of best practice guidelines in patients with acute coronary syndromes is challenging for hospitals.
  
  
  METHODS
  A task force addressed gaps in care and adherence to guidelines, and included Emergency Medical Services (EMS) in the decision pathway.
  
  
  RESULTS
  Previously, our institutional performance on most core metrics was in the lower tertile nationally. Task force recommendations and the recognition of EMS's role in care produced significant improvement. Seventy-four percent of our cardiac catheterization laboratory activations were prehospital activations, which resulted in expeditious revascularization. Our composite acute myocardial infarction (MI) performance in 2014 was 97.5% for Q1, 97.2% for Q2, 97.3% for Q3, and 97.3% for Q4. Compliance in most of the individual parameters was greater than 95%.
  
  
  CONCLUSIONS
  Identification of systemic gaps, application of best practice guidelines, and partnering with EMS improved our core measures and patient outcomes without the need for additional resources.
authors.forename: Prajapathi
authors.initials: P
authors.lastname: Lakireddy
authors.forename: Peter
authors.initials: P
authors.lastname: Canning
authors.forename: Juyong
authors.initials: J
authors.lastname: Lee
authors.forename: Michael
authors.initials: M
authors.lastname: Azrin
authors.forename: Aseem
authors.initials: A
authors.lastname: Vashist
mesh_terms: D054058:Acute Coronary Syndrome / Q000191:economics / Q000628:therapy*; D006328:Cardiac Catheterization; D003237:Connecticut; D003363:Cost Control / Q000592:standards; D003362:Cost-Benefit Analysis / Q000592:standards; D003625:Data Collection / Q000592:standards; D016208:Databases, Factual / Q000592:standards; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards*; D004632:Emergency Medical Services / Q000191:economics / Q000592:standards*; D019983:Guideline Adherence; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D009203:Myocardial Infarction / Q000191:economics / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000592:standards; D010348:Patient Care Team / Q000191:economics / Q000592:standards*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000592:standards