- 作者：Marna Rayl Greenberg ; DO ; MPH ; FACEP ; William F. Bond ; MD ; Richard S. MacKenzie ; MD ; Rezarta Lloyd ; DO ; Monisha Bindra ; DO ; MPH ; Valerie A. Rupp ; RN ; BSN ; Anne-Marie Crown ; MEd ; James F. Reed III ; PhD
- 关键词：gender disparity ; NSTEMI ; performance improvement
- 刊名：Journal of Emergency Medicine
- 出版年：2012
- 期刊代码：156_07364679
- 类别：med
- 出版时间：May, 2012
- 卷：42
- 期：5
- 页码：588-597
- 文件大小：637 K
Background
Many studies have looked at differences between men and women with acute coronary syndrome. These studies demonstrate that women have worse outcomes, receive fewer invasive interventions, and experience delay in the initiation of established medical therapies.Objective
Using innovative technology, we set out to unveil and resolve any gender disparities in the evaluation and treatment of patients presenting with a positive troponin while in the emergency department. Our goal was to assess the feasibility of using a business management query system to create an automated data report that could identify deficiencies in standards of care and be used to improve the quality of treatment we provide our patients.
Methods
Over a 12-month period, key markers for patients with non-ST elevation myocardial infarction (NSTEMI) were tracked (e.g., time to electrocardiogram, door to medications). During this time, educational endeavors were initiated utilizing McKesson鈥檚 Horizon Business Insight鈩?(McKesson Information Solutions, Alpharetta, GA) to illustrate gender differences in standard therapy. Subsequently, indicators were evaluated for improvement.
Results
Substantial improvements in key indicators for management of NSTEMI were obtained and gender differences minimized where education was provided.
Conclusion
The integration of these information systems allowed us to create a successful performance improvement tool and, as an added benefit, nearly eliminated the need for manual retrospective chart reviews.