Perspectives on Inter-Hospital AMI Care: Timing & Documentation at the New Brunswick Heart Centre Cleo Cyr RN, BN, MHS Saint John, NB.

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Presentation transcript:

Perspectives on Inter-Hospital AMI Care: Timing & Documentation at the New Brunswick Heart Centre Cleo Cyr RN, BN, MHS Saint John, NB

Who We Are: Provincial referral centre for tertiary cardiac care in New Brunswick and surrounding areas. Services include cardiology, interventional cardiology, cardiac surgery, heart function clinic and cardiac rehab Population served approx.750, – 5000 patients per year

ACS Multi-department Tool Joined SHN Sept 2005/Retrospective Analysis Team developed multi-department tool AMI Tool AMI Tool Issues included discrepancies in arrival times, ECG times, time to physician assessment, time to cardiology consult.

Safer Health Care Now! AMI Indicators Safer Health Care Now! Goals SJRH Retrospective Baseline Results 10 month period from Sept 2004 – June 2005 (n=95) Full Implementation Results STEMI & NTEMI March-October 2006 (n=128) Full Implementation Results November 2006 to February 2007 STEMI Pts only n =28 ASA at Arrival90%100%96%100% ASA at Discharge90%100% Beta Blocker at Discharge90%97.6%96.5%100% Thrombolytic Agent within 30 minutes85%*72.4%93.6%84% PCI within 90 minutes90%*77.8%100% ACE/ARB on Discharge (EF <40%) 85%86.9%100% Adult Cigarette Smoking Cessation Advice100%*78.7%92%100% Lipid Lowering Med on dischargeNA Until April %97.5%100% Perfect Care95%*74.5%92%90% Other data collected Cardiac Rehab Referrals**NA60%80%81% Clopidogrel on discharge when indicated**NANot Assessed100%97% *Components of care not at Safer Health Care Now! goals on Retrospective Baseline Analysis. ** Not applicable

Tests of Change Multiple cycles with AMI Tool development and implementation Multi-disciplinary Staff Buy – in

Safer Health Care Now! Improving AMI Care SJRH STEMI: Time to 1st ECG in Minutes March 2006 – February 2007 (Avg 7.4 min n=90)

Time to Charted Physician Assessment (ED) in minutes for STEMI Pts. March 2006 – February 2007 (Avg 8.7 min n=90)

Change Ideas Spread Long Term goal for inclusion of data in daily charting D/C meds D/C ChecklistKnow Your Targets D/C medsD/C ChecklistKnow Your Targets More info NBHC Newsbeat NBHC Newsbeat

Questions? Thank you! Contact Information: Name: Cleo Cyr Address: PO Box 2100 NB Heart Centre. Saint John, NB E2L 4L2 Phone/