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dc.contributor.authorDarling, Chad E.
dc.contributor.authorSmith, Craig S.
dc.contributor.authorSun, Jiaoyuan E.
dc.contributor.authorKlaucke, Christian G.
dc.contributor.authorLerner, Joshua
dc.contributor.authorCyr, Jay
dc.contributor.authorPaige, Peter G.
dc.contributor.authorPaige, Paula
dc.contributor.authorBird, Steven B.
dc.date2022-08-11T08:08:29.000
dc.date.accessioned2022-08-23T15:56:35Z
dc.date.available2022-08-23T15:56:35Z
dc.date.issued2013-01-01
dc.date.submitted2013-07-26
dc.identifier.citation<p>Jt Comm J Qual Patient Saf. 2013 Jan;39(1):16-21.</p>
dc.identifier.issn1553-7250 (Linking)
dc.identifier.doi10.1016/S1553-7250(13)39004-7
dc.identifier.pmid23367648
dc.identifier.urihttp://hdl.handle.net/20.500.14038/29998
dc.description.abstractBACKGROUND: Efforts to reduce door-to-balloon (DTB) times for patients presenting with an ST-elevation myocardial infarction (STEMI) are widespread. Reductions in DTB times have been shown to reduce short-term mortality and decrease inpatient length of stay (LOS) in these high-risk patients. However, there is a limited literature examining the effect that these quality improvement (QI) initiatives have on patient care costs. METHODS: A STEMI QI program (Cardiac Alert Team [CAT]) initiative was instituted in July 2006 at a single tertiary care medical center located in central Massachusetts. Information was collected on cost data and selected clinical outcomes for consecutively admitted patients with a STEMI. Differences in adjusted hospital costs were compared in three cohorts of patients hospitalized with a STEMI: one before the CAT initiative began (January 2005-June 2006) and two after (October 1, 2007-September 30, 2009, and October 1, 2009-September 30, 2011). RESULTS: Before the CAT initiative, the average direct inpatient costs related to the care of these patients was $14,634, which decreased to $13,308 (-9.1%) and $13,567 (-7.3%) in the two sequential periods of the study after the CAT initiative was well established. Mean DTB times were 91 minutes before the CAT initiative and were reduced to 55 and 61 minutes in the follow-up periods (p < .001). There was a nonsignificant reduction in LOS from 4.4 days pre-CAT to 3.6 days in both of the post-CAT periods (p = .11). CONCLUSIONS: A QI program aimed at reducing DTB times for patients with a STEMI also led to a significant reduction in inpatient care costs. The greatest reduction in costs was related to cardiac catheterization, which was not expected and was likely a result of standardization of care and identification of practice inefficiencies.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=23367648&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/S1553-7250(13)39004-7
dc.subject*Clinical Protocols
dc.subjectCommunication
dc.subjectCost Savings
dc.subjectElectrocardiography
dc.subjectElectronic Health Records
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMassachusetts
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subjectQuality Improvement
dc.subjectRetrospective Studies
dc.subjectCardiology
dc.subjectCardiovascular Diseases
dc.subjectEmergency Medicine
dc.subjectHealth and Medical Administration
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.titleCost reductions associated with a quality improvement initiative for patients with ST-elevation myocardial infarction
dc.typeJournal Article
dc.source.journaltitleJoint Commission journal on quality and patient safety / Joint Commission Resources
dc.source.volume39
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/229
dc.identifier.contextkey4352240
html.description.abstract<p>BACKGROUND: Efforts to reduce door-to-balloon (DTB) times for patients presenting with an ST-elevation myocardial infarction (STEMI) are widespread. Reductions in DTB times have been shown to reduce short-term mortality and decrease inpatient length of stay (LOS) in these high-risk patients. However, there is a limited literature examining the effect that these quality improvement (QI) initiatives have on patient care costs.</p> <p>METHODS: A STEMI QI program (Cardiac Alert Team [CAT]) initiative was instituted in July 2006 at a single tertiary care medical center located in central Massachusetts. Information was collected on cost data and selected clinical outcomes for consecutively admitted patients with a STEMI. Differences in adjusted hospital costs were compared in three cohorts of patients hospitalized with a STEMI: one before the CAT initiative began (January 2005-June 2006) and two after (October 1, 2007-September 30, 2009, and October 1, 2009-September 30, 2011).</p> <p>RESULTS: Before the CAT initiative, the average direct inpatient costs related to the care of these patients was $14,634, which decreased to $13,308 (-9.1%) and $13,567 (-7.3%) in the two sequential periods of the study after the CAT initiative was well established. Mean DTB times were 91 minutes before the CAT initiative and were reduced to 55 and 61 minutes in the follow-up periods (p < .001). There was a nonsignificant reduction in LOS from 4.4 days pre-CAT to 3.6 days in both of the post-CAT periods (p = .11).</p> <p>CONCLUSIONS: A QI program aimed at reducing DTB times for patients with a STEMI also led to a significant reduction in inpatient care costs. The greatest reduction in costs was related to cardiac catheterization, which was not expected and was likely a result of standardization of care and identification of practice inefficiencies.</p>
dc.identifier.submissionpathfaculty_pubs/229
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentDepartment of Emergency Medicine
dc.source.pages16-21


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