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Study Develops New System for Identifying Successful Hospital Quality Improvements

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Research Alert: May 22, 2001

Preliminary findings from an ongoing three-year study funded by the Agency for Healthcare Research and Quality (AHRQ) show that a new classification system could help hospitals identify areas where they need to improve care and could provide them with key information to achieve their quality improvements goals.

Researchers at the Yale University used the administration of beta-blockers (medications that slow the heart rate during and after a heart attack) as an interview topic in developing the classification system. Between October 1996 and September 1999, they interviewed hospital personnel at eight hospitals around the country to learn about their efforts in improving the use of beta-blockers with heart attack patients. The researchers organized the data from these interviews under the six factors comprising the classification system: goals for improvement, administrative support, clinician support, design and implementation style, use of data, and contextual information such as hospital size.

The researchers then ranked the hospitals into "high performing" and "low performing" groups based on their use of beta-blockers. The researchers found that those hospitals more likely to prescribe beta-blockers (high performing) had similar characteristics: solid support from their hospital administration, strong physician leadership, shared goals of improving medical practice, and an effective way of monitoring progress. Generally, these characteristics were not present in the low performing hospitals.

Study findings indicate that information from this system may provide hospitals with concrete guidance to help them plan effective interventions to elevate clinical performance and to improve the overall care and outcomes of their patients.

The study "A Qualitative Study of Increasing B-Blocker Use After Myocardial Infarction" is published in the May 23, 2001, issue of the Journal of the American Medical Association. The authors are: Elizabeth H. Bradley, Ph.D.; Eric S. Holmboe, M.D.; Jennifer A. Mattera, M.P.H.; Sarah A. Roumanis, RN; Martha J. Radford, M.D.; and Harlan M. Krumholz, M.D., of Yale University School of Medicine.

Editor's Note: For further details or interviews with Drs. Krumholz and Bradley, contact Jacqueline Weaver of Yale University at (203) 432-8555.

For more information, please contact AHRQ Public Affairs, (301) 427-1364:.


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