Heart attack survival varies widely among hospitals, study finds

The odds you’ll survive a heart attack vary widely depending on where you’re treated in the United States, according to a new study by Yale University researchers.

Hospitals that follow five simple strategies — including good teamwork and having cardiologists on hand 24/7 — have twice the 30-day survival rates of other medical centers, the study found.

But fewer than 10 per cent of the 500-plus US hospitals studied follow even four of the five practices, the study authors said.

“If we could implement all of the strategies across the nation, we would save thousands of lives annually,” said lead researcher Elizabeth Bradley, a professor of public health at the Yale School of Public Health in New Haven, Conn.

“Relatively simple strategies and a culture that focuses not on hiding problems but on finding and solving problems is the best medicine we can give ourselves.”

The strategies include monthly meetings with doctors and paramedics to review heart attack cases; having cardiologists always available; encouraging creative problem solving; specialising nursing duties and better teamwork between doctors and nurses.

Encouraging creative problem-solving and better doctor-nurse teamwork appeared to have the most effect, reducing deaths by 0.84 per cent and 0.88 per cent respectively.

Monthly reviews with doctors and emergency transport personnel lowered deaths by 0.70 per cent; keeping heart specialists on site brought deaths down 0.54 per cent and using only specialized nurses cut deaths by 0.44 per cent.

“These strategies are a mix of concrete processes and the overall culture of the hospital,” Bradley said. They are also “relatively inexpensive and do not require a lot of capital investment, but rather reflect how people work with each other.”

For the study, published in the May 1 issue of the Annals of Internal Medicine, Bradley’s team looked at deaths after heart attacks in 537 hospitals from January 2008 to December 2009.

Fewer than one-quarter of the hospitals held monthly meetings with the paramedics who transported heart attack patients, and only 14 per cent had a cardiologist on duty at all times, the study found.

Having a pharmacist accompany doctors on medical rounds also improved odds of survival, but just 35 per cent of the hospitals studied did so.

Still, while these management strategies were associated with improved survival rates, the authors cautioned that the study cannot establish cause and effect.

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