Other Heart Attack Measures



ACE-I/ARB at Discharge (AMI)

What are we measuring and why?

MGH tracks the percentage of eligible adult heart attack patients who were given prescriptions at discharge for either of two classes of drugs: an ACE inhibitor (ACE-I), or an angiotensin receptor blocker (ARB). These drugs reduce blood pressure and strengthen the heartbeat. National guidelines recommend both of these drugs, which have been found to help patients live longer than they would without them.

How are we doing and how do we compare to best practice?

This data is no longer collected by the Joint Commission, nor is it publically reported. Over the past two years, MGH has consistently performing at 91% and above.  Since 2010, 91% or greater of heart attack patients who met the clinical criteria, received an ACE-I or ARB. Our performance for the last reporting period, January 2014 to December 2014 was 97%.  The performance for all Joint Commission accredited hospitals was 98%.

Click to see MGH’s performance on this measure by patients’ race.

 
  • Current Scores
  • Scores Over Time
  • Higher values are better
98% 100% 97%

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

N.B. Data for this measure is no longer being collected, nor is it publically reported.

MGH: Jan 14-Dec 14
TJC: Jan 14-Dec 14

93 93 92 92 99 97 99 99 98 98 98 98 98 98 98 98 100 100 100 100 100 100 100 100

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

N.B. Data for this measure is no longer being collected, nor is it publically reported.



What are we doing to improve?

MGH has used a number of approaches to improve adherence with this guideline, including clinician to clinician education and reminders. In addition, we are enhancing our computerized decision support, so that before a heart attack patient is discharged, the physician must either prescribe an ACE-I or ARB, or indicate that it is not appropriate. These types of interventions are used selectively to improve the reliability with which the right care is delivered.

What can you do?

If you or a family member are hospitalized with a heart attack, you can play a role in ensuring the quality of care by being aware of the availability and use of ACE-I or ARBs and asking your physician if you will be receiving a prescription for one of them at hospital discharge. If the physician suggests that such drugs are not appropriate, ask why they are not recommended so that you understand why these drugs may not be right for you.

 

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