NCPA - National Center for Policy Analysis


August 3, 2007

Two reports published by the American Heart Association show the improvements in care that can be made when teams from small community hospitals, emergency services and major medical centers team up to systematically tackle one of the nation's top killers, says the Wall Street Journal.

Minnesota is at the forefront of this type of treatment, and the success of their programs highlights a broader theme in medicine:

  • Improvement in medicine is often the result of applying existing knowledge in a standardized, predictable way.
  • The Minneapolis team devised a detailed protocol to rapidly transfer patients from rural hospitals within a 210-mile radius of Minneapolis to Abbott Northwestern for angioplasty.
  • No fancy new technology was required -- just a standard regimen of drugs and care.
  • What's different is the attention to detail, including continuous feedback and discussion about how to make improvements when targets are missed.

Some deride the approach as "cookbook medicine."  But the evidence shows that poorly organized systems deliver hit-or-miss care.  The Minnesota efforts have slashed door-to-balloon times -- measured from the arrival at the first hospital to getting the artery open with an angioplasty balloon at a hospital equipped for the procedure.  They've also reduced length of hospital stays and showed promise in reducing mortality and other major complications of heart attacks.

Source: Ron Winslow, "Minnesota: Where All the Heart-Attack Care is Above Average," Wall Street Journal, August 3, 2007.

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