title: Interorganizational Collaboration in Emergency Cardiovascular Care.
abstract: Interorganizational collaboration management theory contends that cooperation between distinct but related organizations can yield innovation and competitive advantage to the participating organization. Yet, it is unclear if a multi-institutional collaborative can improve quality outcomes across communities.
  
  
  
  We developed a large regional collaborative network of 15 hospitals and 24 emergency medical service agencies surrounding Dallas, Texas, and collected patient-level data on treatment times for acute myocardial infarctions. Using a pre-/posttest research design, we applied median tests of differences to explore outcome changes between groups and over the 6-year period, using data extracted from participating hospital electronic health records.
  
  
  
  We analyzed temporal trends and changes in treatment times for 2302 patients with ST-elevation myocardial infarction between the pre- and posttest groups. We found a statistically significant 19-minute median reduction in the key outcome metric (total ischemic time, the time difference between the patient's first reported symptoms and the definitive opening of the artery). This represents a 10.8% community-wide improvement over time.
  
  
  
  Interorganizational collaboration focused on quality improvement can impact population health across a community. This study provides a basis for broader understanding and participation by health care organizations in multi-institutional community change efforts.
authors.affiliation: School of Biomedical Informatics, The University of Texas Health Science Center, Houston (Drs Langabeer and Champagne-Langabeer); Metropolitan State University of Denver, Denver, Colorado (Dr Helton); American Heart Association, Denver, Colorado (Ms Segrest); Texas A&M University School of Public Health, College Station (Dr Kash); Department of Healthcare Leadership & Management, Medical University of South Carolina, Charleston (Dr DelliFraine); and The University of Texas Southwestern Medical Center, Dallas (Dr Fowler).
authors.forename: James R
authors.initials: JR
authors.lastname: Langabeer
authors.forename: Tiffany
authors.initials: T
authors.lastname: Champagne-Langabeer
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Helton
authors.forename: Wendy
authors.initials: W
authors.lastname: Segrest
authors.forename: Bita
authors.initials: B
authors.lastname: Kash
authors.forename: Jami
authors.initials: J
authors.lastname: DelliFraine
authors.forename: Raymond
authors.initials: R
authors.lastname: Fowler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D005260:Female; D006739:Hospital Administration / Q000706:statistics & numerical data*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D013781:Texas; D016896:Treatment Outcome