Keys to Successful Heart Attack Treatment

The researchers visited each of the hospitals and conducted extensive interviews with the staff at each hospital, from the top administrators down to the technical-support staff. They found the following eight common characteristics at these hospitals: (1) an explicit commitment to reduce delays throughout the process; (2) senior management support for quality improvement; (3) innovative protocols; (4) flexibility in refining those protocols; (5) collaborative teams across nursing, cardiology, and emergency services; (6) real-time data feedback to measure success; (7) an organizational culture that made the hospitals resilient to setback; and (8) the pursuit of contrasting approaches simultaneously while balancing the tensions between them.

All of these top hospitals share eight common characteristics that drive their ability to deliver fast, effective treatment to patients with ST-elevation acute myocardial infarction (STEMI), said senior author Harlan M. Krumholz, M.D. This study has direct and important information for hospitals around the country.

We found that success involved much more than skilled individual doctors and nurses, said lead author Elizabeth Bradley, associate professor in the department of epidemiology and public health at Yale. What distinguished these hospitals was how well they were organized, how teams functioned together, how the culture rewarded quality improvement, and how they dealt with setbacks.



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Yale School of Medicine