• W Frank Peacock, Michael C Kontos, Ezra Amsterdam, Christopher P Cannon, Deborah Diercks, Lee Garvey, Louis Graff, DaJuanicia Holmes, Kay Styer Holmes, James McCord, Kristin Newby, Matthew Roe, Shahriar Dadkhah, Angela Siler-Fisher, and Michael Ross.
• Baylor College of Medicine, Ben Taub Hospital, 1504 Taub Loop, Houston, TX 77030, USA. Frankpeacock@gmail.com
• Crit Pathw Cardiol. 2013 Sep 1;12(3):116-20.

BackgroundThe Society of Cardiovascular Patient Care (SCPC) accredits hospital acute coronary syndrome management. The influence of accreditation on the subset of patients diagnosed with acute myocardial infarction (AMI) is unknown. Our purpose was to describe the association between SCPC accreditation and hospital quality metric performance among AMI patients enrolled in ACTION Registry-GWTG (ACTION-GWTG). This program is a voluntary registry that receives self-reported hospital AMI quality metrics data and provides quarterly feedback to 487 US hospitals.MethodsUsing urban nonacademic hospital registry data from January 1, 2007, to June 30, 2010, we performed a 1 to 2 matched pairs analysis, selecting 14 of 733 (1.9%) SCPC accredited and 28 of 309 (9.1%) nonaccredited registry facilities to compare changes in quality metrics between the year before and after SCPC accreditation.ResultsAll hospitals improved quality metric compliance during the study period. Nonaccredited hospitals started with slightly lower rates of AMI composite score 1 year before accreditation. Although improvement compared with baseline was greater for nonaccredited hospitals (odds ratio = 1.27; 95% confidence interval: 1.20, 1.35) than accredited hospitals (odds ratio = 1.15; 95% confidence interval: 1.07, 1.23) (P = 0.022), the group ended with similar compliance scores (92.1% vs. 92.2%, respectively). Improvements in evaluating left ventricular function (P = 0.0001), adult smoking cessation advice (P = 0.0063), and cardiac rehab referral (P = 0.0020) were greater among nonaccredited hospitals, whereas accredited hospitals had greater improvement in discharge angiotensin-converting-enzyme inhibitor or angiotensin II receptor blocker use for left ventricular systolic dysfunction (P = 0.0238).ConclusionsAll hospitals had high rates of quality metric compliance and finished with similar overall AMI performance composite scores after 1 year.

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