Abstract 16: Society of Chest Pain Centers accreditation is associated with improved cardiac service line outcomes in Virginia hospitals

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Introduction: Hospitals in Virginia publicly report mortality outcomes on cardiac patients voluntarily. The Society of Chest Pain Centers (SCPC) is a process improvement organization that uses a standardized system of accreditation to recognize hospitals meeting specific process and organizational standards in acute cardiac care. Hypothesis: An association may exist between a hospital’s SCPC accreditation status and the reported mortality index for cardiology patients who do not undergo percutaneous or surgical coronary intervention. Methods: Self-reported data on non-interventional cardiac service line mortality for acute care hospitals in Virginia for calendar year 2009 were obtained from the Virginia Health Information website ( www.VHI.org ). Expected mortality rates were calculated by quality personnel at each hospital using standardized methodologies. Actual to expected (A:E) mortality ratios were compared between SCPC accredited an d non-accredited hospitals. Two-tailed t tests were used for comparisons. Results: Data were available from 77 acute care hospitals representing a total of 57,976 non-interventional cardiology patient cases in Virginia for 2009. 17 SCPC-accredited hospitals accounted for 19,246 cases and 60 non-accredited hospitals accounted for 38,730 cases. Using volume-weighted averages, the mean A:E mortality ratio was 0.91 at SCPC-accredited hospitals vs. 1.14 at non-accredited hospitals. (p <0.0001, 95% CI for difference in means: -0.24 to -0.22). In high-volume centers (>500 cases/yr), there was a significantly decreased A:E mortality ratio in accredited centers (n=13) vs. non-accredited ones (n=29) (0.86 vs. 1.11, p <0.0001; 95% CI for difference in means: -0.26 to -0.24). In low-volume centers (<500 cases/yr), there were higher than expected A:E mortality ratios in both the accredited (n=4) and non-accredited groups (n=31) (1.54 and 1.24, respectively). Conclusions: SCPC accreditation was associated with a lower A:E mortality ratio in Virginia hospitals. This lower mortality ratio was more prominent in hospitals having higher volumes of non-interventional cardiac cases. Smaller volume centers had higher than expected mortality ratios regardless of accreditation status.