However, composite adherence performance varied widely (median composite adherence scores from lowest to highest hospital quartiles, 63% vs 82% ). There was modest correlation in hospital performance among the individual ACS process metrics.
Overall, the 9 ACC/AHA guideline-recommended treatments were adhered to in 74% of eligible instances. Use of 9 ACC/AHA class I guideline-recommended treatments and the correlation among hospitals' use of individual care processes as well as overall composite adherence rates. identify characteristics predictive of higher guideline adherence, and to assess whether hospitals' overall composite guideline adherence was associated with observed and risk-adjusted in-hospital mortality rates.Īn observational analysis of hospital care in 350 academic and nonacademic US centers of 64,775 patients enrolled in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) National Quality Improvement Initiative between January 1, 2001, and September 30, 2003, presenting with chest pain and positive electrocardiographic changes or cardiac biomarkers consistent with non-ST-segment elevation acute coronary syndrome (ACS). To evaluate contemporary care practices consistent with the American College of Cardiology/American Heart Association (ACC/AHA) guideline recommendations, to examine how hospital performance varied among centers, to. Selected care processes are increasingly being used to measure hospital quality however, data regarding the association between hospital process performance and outcomes are limited.
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