Field of Work: Improving the overall quality of cardiac care while reducing racial, ethnic and language disparities
Problem Synopsis: Health care disparities—differences in the use of health care services and health outcomes—between minorities and Whites have received widespread attention. In 2002, the Institute of Medicine (IOM) report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care noted that minorities are less likely than Whites to receive the health care services they need in many disease areas; and racial and ethnic disparities in care were especially likely in the treatment of heart disease. The IOM report also recommended the use of evidence-based guidelines to provide more consistent and equitable care for all patients.
Synopsis of the Work: The 10 hospitals participating in Expecting Success: Excellence in Cardiac Care developed and shared tools for improving care for all heart attack or heart failure patients. (Heart failure is a condition in which the heart cannot pump enough blood to meet the body's needs.)
Teams within each hospital worked together via a learning network. They used evidence-based guidelines to improve and track the quality of inpatient cardiac care and also worked on community demonstration projects to improve care as heart patients transitioned from inpatient to outpatient care.
Program Director Bruce Siegel, MD, MPH, reported in Expecting Success: Excellence in Cardiac Care: Results from Robert Wood Johnson Foundation Quality Improvement Collaborative that the Expecting Success hospitals institutionalized, or “hardwired,” the collection of self-reported patient race, ethnicity and language data and tracked core measures of care for patients who had a heart attack or heart failure. “We showed you can collect data on race and ethnicity and use it to improve quality, and you can do it relatively easily,” said Siegel.
The participating hospitals also improved their quality of care. Within one year, every hospital that participated in the program had increased its percentage of patients receiving all core measure of care for heart attack and heart failure. This improvement continued throughout the program.