In a qualitative study of 11 U.S. hospitals and 158 staff members, high-performing hospitals in AMI mortality were characterized by an organizational culture supporting broad improvement efforts.
Observational (n=158)
Yes
BACKGROUND: Mortality rates for patients with acute myocardial infarction (AMI) vary substantially across hospitals, even when adjusted for patient severity; however, little is known about hospital factors that may influence this variation. OBJECTIVE: To identify factors that may be related to better performance in AMI care, as measured by risk-standardized mortality rates. DESIGN: Qualitative study that used site visits and in-depth interviews. SETTING: Eleven U.S. hospitals that ranked in either the top or the bottom 5% in risk-standardized mortality rates for 2 recent years of data from the Centers for Medicare however, these did not systematically differentiate high-performing from low-performing hospitals. LIMITATION: The qualitative design informed the generation of hypotheses, and statistical associations could not be assessed. CONCLUSION: High-performing hospitals were characterized by an organizational culture that supported efforts to improve AMI care across the hospital. Evidence-based protocols and processes, although important, may not be sufficient for achieving high hospital performance in care for patients with AMI. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality, United Health Foundation, and the Commonwealth Fund.
Curry et al. (Tue,) conducted a observational in Acute myocardial infarction (n=158). Organizational culture and hospital factors vs. Low-performing hospitals was evaluated on Hospital factors related to better performance in AMI care. In a qualitative study of 11 U.S. hospitals and 158 staff members, high-performing hospitals in AMI mortality were characterized by an organizational culture supporting broad improvement efforts.