1. AMI Discharge Care Improved: At Regional Health Authority Four Edmundston, N.-B. Carole Ruest, RN

2. Who We Are: 205 bed hospital The RHA4 consists of 3 facilities : –Edmundston Regional Hospital –Grand-Falls General Hospital –Hotel-Dieu Saint-Joseph of Saint-Quentin 6% of admissions thru ED Population served approx.50,000

3. Discharge AIM Statements ASA ≥ 90 % Beta blocker ≥ 90 % ACE inhibitor or ARB ≥ 85 % Statin ≥ 95 % Smoking counselling = 100 %

4. Team Members Cardiac rehabilitation nurse Head nurse assistant –Emergency room –Intensive Care Unit –Department of Medecine Internist Family doctor

5. Change Ideas Documentation tools Same team on site for inpatients and outpatients for smoking cessation counselling Discharge medication reviewed by member team and data brought to the internist and family doctor

6. Measures (for the last 2 years) CriteriaResults ASA at discharge100 % Beta Blocker at discharge100 % ACE Inhibitor or ARB at discharge100 % Smoking cessation counselling100 % Statin (since April ’07)100 %

7. Lessons Learned Have a team Collect data concurrently

8. Challenges Find a team Find time Make people buy-in Language Collecting data tool Clock time not synchronize throughout the hospital Small number of patients (transfer out)

9. Next Steps Regionalize the strategy Set up a team for the 2 other facilities Find a way to make clock time consistant throughout the hospital

10. Questions? Thank you! Contact Information: Carole Ruest Name : Regional Health Authority Four Address : 275, boulevard Hébert, Edmundston (NB) E3V 4E4 Phone/email : 506-739-2719, Carole.Ruest@rrs4.ca