ACC Quality Improvement Initiatives: Supporting Patient Outcomes at Hospitals and Institutions

Quality improvement (QI) has been an imperative in healthcare for over a decade, and, not surprisingly, QI is especially critical to all involved in providing cardiovascular care at hospitals and institutions across the United States. In July 2015, CardioSurve surveyed nearly 450 quality directors, cardiology department chiefs/directors, and registry participants to explore perceptions of QI at their institutions.

Top areas of focus for quality improvementOverall, the study finds that QI at hospitals and institutions is primarily hinged on increasing patient satisfaction (84%), improving outcomes/reducing admissions (80%), and reducing costs (66%). To that end, the ability to compare institutional data to national norms and track overall improvement in quality and outcomes in a timely, efficient manner is vital.

The ACC launched its Quality Improvement for Institutions (QII) program last year to provide healthcare institutions with a comprehensive suite of cardiovascular registries and service solutions - supporting quality clinical care and improving patient outcomes. As captured by the QII tag line “Simple Solutions/Big Impact,” QII pulls together in one program the College’s suite of NCDR hospital and outpatient registries, clinical toolkits to help close identified gaps in evidence-based care, and quality improvement initiatives, such as Hospital to Home, Patient Navigator, and Surviving MI, which target specific areas of improvement.

Participants in ACC’s QII offerings recognize the positive impact that these resources have had on patient care in their facilities. According to health professionals, patient registries such as NCDR (73%) are among the most commonly participated in QI resources, and more than half of NCDR participants (54%) believe that these registries have made a strong contribution to their institution’s quality of cardiovascular services.

QII contributions to quality improvementAdditionally, more than half of professionals (54%) report participation in the Door to Balloon (D2B) Initiative, designed to help hospitals meet guideline-recommended D2B times of 90 minutes or less. More than 4 out of 5 D2B participants (82%) feel that participation in this program has strongly contributed to the improvement of their institution’s cardiovascular services.

In general, the benefits of registry participation include benchmarking, improvement in outcomes and the ability to focus on specific areas of improvement. More than 3 out of 4 participants (76%) report that they address QI challenges through the use of benchmarking, tracking and monitoring. A similar percentage (75%) indicate that they have created special quality improvement teams and/or committees to address quality concerns. In addition, two out of three professionals (67%) believe that opportunities to share insights regarding best practices and improving practices related to patient care are the most desired support for their institutions in their quality improvement efforts.

Despite these recognized benefits, many challenges still exist to the implementation of QI initiatives at facilities. Lack of time (66%), staffing resources (57%) and cost (50%) continue to inhibit institutions from taking on new quality improvement initiatives. To quote one healthcare professional, “I’m overwhelmed with data and projects. Resources are shrinking, and unless I can show concrete benefits it’s hard to imagine tackling something else.”

Moving forward, the ACC has opportunities to reach key decision makers, quality directors, cardiovascular chiefs and hospital executives in order to effectively communicate to them the benefits of the QII program and how its features can address some of the challenges to QI implementation in healthcare facilities. In addition to the larger perspective provided by the NCDR registries, programs such as Door to Balloon (D2B), Hospital to Home (H2H), Surviving MI, and other initiatives can demonstrate how focused quality initiatives and toolkits are designed to support local efforts in achieving specific goals. The insights from the study support the need for the QII program and its goal of promoting continuous collaboration and the dissemination of practical lessons learned.

In the end, for any QI program to be successful it should follow a simple formula, as one professional noted, “Continue to find new ways to assist hospitals and providers to focus on and improve the quality of care we deliver to our patients.” For more information about ACC’s Quality Improvement for Institutions program, please visit

Keywords: ACC Publications, Cooperative Behavior, Goals, Helping Behavior, Hospitals, Outpatients, Patient Care, Patient Navigation, Patient Satisfaction, Quality Improvement, Registries

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