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Hospitals Vary in Basic Care for Heart Patients

Posted on: Tuesday, 30 August 2005, 21:00 CDT

A third-year medical student knows the drill.

Heart attack patients should receive aspirin and blood pressure medication when they enter and leave the hospital.

But this routine is more routine in some area hospitals than others.

Sherman Hospital in Elgin delivered basic treatments known to save lives after a heart attack to every heart attack patient that passed through its doors during a six-month period.

Sherman was among the five busiest in the country to do so, according to a recent study in the New England Journal of Medicine.

Other local hospitals were less consistent.

Condell Hospital in Libertyville failed to give more than 20 percent of patients a beta-blocker at arrival, according to hospital records. Beta-blockers help prevent additional heart attacks by reducing the heart's workload.

And nearly two in 10 heart attack patients didn't receive aspirin when they arrived at Condell.

One in every 10 heart attack patients at Delnor-Community Hospital in Geneva didn't receive a beta-blocker at discharge.

And more than one in 10 didn't receive a beta-blocker upon arriving at Northwest Community Hospital in Arlington Heights.

Nationally, 11 percent of heart attack patients did not receive standard therapies, according to the study.

"It's a good wakeup call," said Dr. Vincent Bufalino, president of Midwest Heart Specialists and medical director of Edward Heart Hospital in Naperville.

Hospitals began publicly reporting performance data for treatment of heart attacks, congestive heart failure and pneumonia this spring in exchange for Medicare bonuses.

The program, called Hospital Compare, allows the federal government to track the performance of hospitals.

The early numbers cover the first six months of 2004. The next wave of results, due out shortly, covers the second half of the year.

The government's measuring sticks for the treatment of heart attacks - whether a patient receives a beta-blocker and aspirin upon entering and leaving the hospital and advice about quitting smoking - represent universally accepted standards of care.

"We know if everybody wears a seat belt, they'll do better," said Dr. Ian Jones, vice president for clinical performance at Sherman.

"It's the same with this. There will probably be a 30 percent reduction in (future) heart attacks by following this criteria."

Sherman has increased compliance by 30 to 40 percent since it began tracking these indicators, Jones said.

"Five years ago we were performing about the same as the average hospital in the country, which is to say, not very well."

Many hospitals attribute their low numbers to poor record- keeping.

"Condell has been working diligently since April of this year to gather the proper information, which will result in improved scores in general," a hospital spokeswoman wrote in a statement.

Since the numbers were first reported, hospitals in the state have begun putting in place new compliance measures, including preprinting the orders doctors give to patients to include the key indicators tracked by the government.

"We really rallied a team around it," said Dr. Bonnie DeGrande, director of cardiovascular services at Northwest Community Hospital in Arlington Heights.

Our beta-blocker scores "really got everybody's attention, and we fixed it," she said.

The most recent numbers show the hospital at 100 percent compliance, she said.

Hospital administrators say these numbers are only a first step toward a more meaningful grading system that includes how patients do after they leave the hospital.

"These measures are just a tiny little picture in the window," Bufalino said.

Source: Daily Herald; Arlington Heights, Ill.

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