“I am very pleased with the results coming out of this study on cardiac care” says Anthony Vines, President and CEO, Ross Memorial Hospital. “Overall, we are within the provincial benchmark for care of heart attack and heart failure patients and this benchmark represents a very high standard of performance. Participation in this report was voluntary and we are always willing to participate in these studies as the results provide us with an opportunity to enhance accountability to our community and to further improve care for our patients.”

The EFFECT study assesses hospital performance regarding the care provided to heart attack (AMI – acute myocardial infarction) and heart failure (CHF – congestive heart failure) patients. This study also presents, for the first time, clinical benchmarks for AMI and CHF care, which will serve as a guide for continued improvement in hospital cardiac care.

The data for the study was based on data collected from chart reviews of AMI and CHF hospitalizations from 1999 to 2001 in 85 hospital corporations (103 hospital sites). Hospitals were grouped into two phases – the early feedback group (44 hospitals corporations/53 hospitals) and the delayed feedback group, whose results will be released later this fall. Ross Memorial Hospital was in the early feedback group.

“It is interesting to note that cardiovascular diseases are the leading cause of death in Canada (more than 78,000 each year),” explains Mr. Vines. “As well, the study indicates that the economic impact of heart disease is estimated to be approximately $19 billion per year in Canada and makes up 18% of hospitalizations in the country, which is more than any other illness/condition. These statistics are incredible and it is obvious that there is room for additional focus throughout the country on all aspects of cardiac care.”

In the category, ‘AMI Door to Needle Time’, Ross Memorial proved to be among the leaders in the province. The ‘Door to Needle Time’ measures the time from arrival in the emergency department (door) to when the administration of thrombolysis infusion/clot busting drugs (needle) begins. This drug/needle time is critical to the survival of the AMI patient and the provincial benchmark is 30 minutes. Out of 44 hospitals reported, only 12 met this benchmark and Ross Memorial was one of them. Ross Memorial’s Emergency physicians have been trained to administer these drugs when they are required. “This is an outstanding result and we applaud our physicians and nursing staff for this excellent achievement,” comments Mr. Vines.

Ross Memorial also proved to be a leader when it comes to lab testing to determine whether or not a patient is actually experiencing a heart attack (Troponin Level Testing). In this area, Ross Memorial achieved a rating of 96% compared to the provincial average rating of 53%, community hospitals’ average of 49% and the teaching hospitals’ average of 83%.

Ross Memorial also received some below provincial average ratings. However, for most of these indicators, initiatives have been put in place since the data was compiled. These initiatives will help us to further improve on these indicators in future.

For example, with respect to the ‘AMI Secondary Prevention Rate’ (prescribed drugs upon discharge to help prevent the recurrence of AMI), the majority of Ontario hospitals were below the benchmark (>/= 85%) at an overall average of 79%. Since the data was collected, Ross Memorial has developed a care pathway (a plan of care that outlines the detail of treatment that a patient can expect during their hospital stay including the total length of their admission) on the management of acute coronary syndrome. This pathway will help to optimise the medications prescribed on discharge.

Another example is the use of beta-blockers (drugs that reduce the workload on the heart) for both AMI and CHF patients. The Hospital’s rating is representative of the timeframe in which the data was collected since beta-blockers at that time were not widely used/prescribed for CHF. Since then, we have seen increased utilization of beta-blockers. A recent internal study has shown approximately a 50% increase in the use of beta-blockers in CHF patients.

In addition, the Hospital is currently preparing a business plan for the development of a CHF clinic in order to assist patients with counselling, lifestyle changes and ongoing management of their condition.

“It is important to note that we are aware of opportunities for improvement and changes are already underway,” says Mr. Vines. “I would like to take this opportunity to congratulate our staff and physicians for continuing to provide excellent cardiac care for the benefit of our patients.”