1. Making Surgery Safer: Preventing Post Operative Myocardial Infarctions
Loyola University Chicago
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Making Surgery Safer: Preventing Post Operative Myocardial Infarctions
Team Membership
Clinical Departments: Anesthesia, General Surgery, Orthopaedics, Primary Care, and Urology
Hospital Departments: Surgical Admitting Center, Operating Room, Post-Anesthesia Recovery, Pharmacy, and CCE

2. Opportunity Statement
Patients at high risk of postoperative myocardial infarction will receive prophylactic treatment with beta-blockers unless there is a contraindication to this therapy
Goal: To reduce postoperative myocardial infarctions

3. Most Likely Causes For The Current Opportunity
Perioperative Beta blockade is recently identified in the literature as an approach to reduce cardiac complications
Lack of awareness of new literature by LUHS physicians

4. Solutions Implemented
Project chartered by the Quality & Patient Safety Committee of the LUHS Board
Assembled project team
Conducted a literature review
Communicated with other organizations
Drafted LUHS protocol

5. Perioperative Beta Blocker Protocol

6. Solutions Implemented
Provided education to the following audiences:
Anesthesia, Urology, Primary Care, Surgical Admitting Center, Post-Anesthesia Recovery, Inpatient Nurse Managers
Implemented pilot with Urology patients December 1, 2002
Revised protocol and processes based on project data
Added General Surgery patients to the pilot April 1, 2003

7. Progress To Date
48 patients have been enrolled; 41 have completed the protocol
Hypertension is the most common risk factor

8. Progress To Date
There is an opportunity to improve compliance with post operative orders and discharge orders
Among patients completing the protocol there have been no postoperative MI’s

9. Progress To Date

10. Next Steps Continue data collection and analysis
Identify barriers to successful completion of the protocol and implement solutions to resolve
Reminders for postoperative and discharge orders
Determine effectiveness of patient screening
Revise protocol as needed
Expand pilot to other surgical services