Following the Get With The Guidelinesprogram — which was launched by the American Heart Association/American Stroke Association to improve in-hospital quality — helps hospitals deliver better care for a broad range of cardiovascular conditions.
According to a paper released Tuesday in the journal Circulation, hospitals consistently following Get With The Guidelines measures can reduce patients’ length of stay and 30-day readmission rates, reduce disparity gaps in care and subsequently may decrease health care costs.
“As Congress focuses more on Medicare payment reform, programs with a demonstrated track record like Get With The Guidelines can offer innovative ways to improve treatment and provide the quality health care that all Americans deserve,” said A. Gray Ellrodt, M.D., lead author of the paper and chief of medicine at the Berkshire Medical Center in Pittsfield, Mass.
The program was introduced in 2000 by the association to address the substantial gaps in quality of care for cardiovascular disease, including treatment disparities by sex, race/ethnicity and geographic region. Get With The Guidelines provides healthcare teams with information, tools and best practices to help ensure that each patient is treated according to the most current research-based guidelines.
The foundation of these tools are sophisticated databases, called clinical registries, that provide hospitals with the necessary benchmarking data to assess current care to promote improved quality and improved patient outcomes within individual hospitals and across the health care system. These registries also provide a mechanism to evaluate, recognize and provide patients with information regarding hospitals that consistently follow the program’s measures.
For example, the program’s Heart Failure registry was used to examine early follow-up with patients after they left the hospital. The study revealed that patients discharged from hospitals with the lowest early follow-up rate had the highest 30-day readmission rate. To combat this, the information was used to promote efforts to follow-up with heart patients shortly after discharge.
In another instance, program researchers discovered a substantial underuse of implantable cardiac defibrillators (ICD) in women and black patients who could benefit from the treatment, compared to white men. To address this gap, Get With The Guidelines focused educational efforts on the importance of ICD placement in all eligible patients. From 2005 to 2009, this strategy brought about a significant increase in the use of ICD therapy in patients needing it, eliminating these care disparities.
Additionally, a Get With The Guidelines report identified hospital variation in the number of stroke patients who received the clot-busting drug t-PA within one hour of arriving at the hospital. In response, the association has initiated Target Stroke to achieve the 60-minute timeframe for 50 percent of the patients in 1,200 participating hospitals.
Of the 6,280 hospitals registered with the American Hospital Association, nearly a third of them (1,956) participate in at least one Get With The Guideline program. These institutions have submitted over 4 million patient records since the program launched, with over 2 million in the stroke registry alone.
The program now annually enrolls over 40 percent of all index hospitalizations for stroke patients in the United States.