Abstract P128: Get With the Guidelines Coronary Artery Disease Program Helps Attain Quality Care in Minority Population: 5 Year Experience in the Inner City Bronx

Abstract

Background: Gender and race based disparities in health care delivery are reported. Our acute care, non interventional hospital serves a Bronx population comprising predominantly Hispanic/Latino and African Americans. Hypothesis: Get with The Guidelines Coronary Artery Disease (GWTG-CAD) Patient Management Tool helps providers adhere to guideline recommended secondary prevention therapies in hospitalized patients with acute myocardial infarction (AMI), irrespective of gender, ethnicity or race . Our objective was to verify that the program with a dedicated physician champion and staff cardiologists achieved and maintained a high level of adherence in this population by continued education and oversight. Methods: Patients admitted to coronary care unit with diagnosis of AMI were entered into GWTG database. Data entries were both concurrent and retrospective. Guideline recommended therapies were initiated prior to transfer to an interventional facility or discharge. No order sets or checklists were used; however written policy and procedure on AMI management was available as reference, in coronary care unit and Emergency Dept. The 5 year data from January 2004 to December 2008 were analyzed for “defect free care measures” (DFCMs) (% patients receiving all eligible interventions). Chi square testing was done with significance at p<0.05. Results: 728 patient records reviewed, comprising 315 females, 379 males, 525 Hispanics (any race) and 157 non-Hispanics (includes blacks and whites). DFCMs achieved annually from 2004-2008 for sub groups as well as p values are listed in table . Conclusions: The analysis confirms that GWTG program with continuous education of providers helps impart high quality of care (DFCMS) in all subsets, including minority populations. VARIABLE 2004 2005 2006 2007 2008 Male 93.8% (75/80) 97% (65/67) 96.1% (73/76) 100% (93/93) 98.4% (62/63) Female 81.2% (52/64) 91.5% (54/59) 98.3% (58/59) 97% (65/67) 100% (66/66) p value 0.04 0.03 0.79 0.33 0.98 Hispanic (Any Race) 90.5% (86/95) 96.3%(105/109) 96.2%(102/106) 98.4%(125/127) 98.9% (87/88) Non Hispanic (Blacks / Whites) 81.1% (30/37) 84.2% (16/19) 100% (25/25) 97.3% (36/37) 100% (39/39) p value 0.23 0.11 0.73 0.65 0.50