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Hospital teams made a checklist of why such projects fail, tackling them one-by-one so that performance on process measures for heart attack, heart failure, pneumonia and surgical care all exceed 95%.
For one of the measures, "We reduced the time between arrival and treatment of heart attack patients requiring immediate care from around 90 minutes, the national benchmark, to an average of 66 minutes," Pronovost said, which required collaboration between emergency responders, interventional cardiologists, nurses and support staff.
"Now, the hospital's heart attack team is often activated before the patient even reaches the emergency department," he said.
Room for Improvement
In a phone interview, Chassin explained why, even after many hospitals have been evaluated for longer than three years on these core measures, two-thirds still can't make the grade.
"It is extremely unusual for healthcare organizations, especially hospitals, to have any process that functions at 95%, and be able to maintain it even more remarkable.," Chassin said.
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