Hospital quality-improvement coalitions to reduce acute myocardial infarction (AMI) mortality may benefit from the inclusion of pharmacists, according to a report published May 11 in the American Journal of Health-System Pharmacy.

Leslie A. Curry, PhD, MPH, et al., conducted a two-year, mixed-method, interventional study in 10 U.S. hospitals to promote the use of five evidence-based strategies associated with lower risk-standardized mortality rates for AMI patients: The evidence-based strategies included 1) employing creative problem solving, 2) convening monthly meetings with emergency medical services to review AMI cases, 3) having pharmacists participate on rounds for all AMI patients, 4) involving physician and nurse champions for AMI care, and 5) dedicating nurses to cover the cardiac catheterization laboratory. Strategies were measured at baseline, 12 months and 24 months and data were collected via face-to-face interviews at each hospital.

Results showed significant changes in the use of evidence-based strategies over the two-year study period, with the mean number of strategies used per hospital increasing from 2.4 at baseline to 3.9 at 24 months. Innovative approaches for integrating pharmacotherapy and pharmacy practice expertise included information technology solutions, targeted rounding for AMI patients, medication-bridging programs and AMI patient education.

Furthermore, the authors found that the inclusion of pharmacists strengthened relationships across disciplines and allowed them to become routinely embedded in broader quality efforts. The empowerment of pharmacists to solve problems also allowed for local innovation in the implementation of evidence-based strategies, tailoring solutions to fit the hospital context.

“Although previously published evidence about the impact of pharmacist involvement on a variety of clinical outcomes is mixed, several recent systematic reviews suggest that pharmacist expertise positively influences cardiac process-of-care measures and outcomes such as readmissions,” the authors write. “This study’s findings extend the published literature by describing an intervention that successfully engaged pharmacists as part of quality-improvement guiding coalitions.”

Keywords: Pharmacists, Quality Improvement, Patient Readmission, Medical Informatics, Pharmaceutical Services, Pharmacy, Hospitals, Emergency Medical Services, Myocardial Infarction, Cardiac Catheterization

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