Making surgery safer preventing post operative myocardial infarctions
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LOYOLA UNIVERSITY HEALTH SYSTEM. Loyola University Chicago. Making Surgery Safer: Preventing Post Operative Myocardial Infarctions. Team Membership Clinical Departments: Anesthesia, General Surgery, Orthopaedics, Primary Care, and Urology

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LOYOLA

UNIVERSITY

HEALTH SYSTEM

Loyola University Chicago

Making Surgery Safer: Preventing Post Operative Myocardial Infarctions

Team Membership

Clinical Departments: Anesthesia, General Surgery, Orthopaedics, Primary Care, and Urology

Hospital Departments: Surgical Admitting Center, Operating Room, Post-Anesthesia Recovery, Pharmacy, and CCE


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Opportunity Statement

  • Patients at high risk of postoperative myocardial infarction will receive prophylactic treatment with beta-blockers unless there is a contraindication to this therapy

  • Goal: To reduce postoperative myocardial infarctions


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Most Likely Causes For The Current Opportunity

  • Perioperative Beta blockade is recently identified in the literature as an approach to reduce cardiac complications

  • Lack of awareness of new literature by LUHS physicians


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Solutions Implemented

  • Project chartered by the Quality & Patient Safety Committee of the LUHS Board

  • Assembled project team

  • Conducted a literature review

  • Communicated with other organizations

  • Drafted LUHS protocol



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Solutions Implemented

  • Provided education to the following audiences:

    • Anesthesia, Urology, Primary Care, Surgical Admitting Center, Post-Anesthesia Recovery, Inpatient Nurse Managers

  • Implemented pilot with Urology patients December 1, 2002

  • Revised protocol and processes based on project data

  • Added General Surgery patients to the pilot April 1, 2003


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Progress To Date

  • 48 patients have been enrolled; 41 have completed the protocol

  • Hypertension is the most common risk factor


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Progress To Date

  • There is an opportunity to improve compliance with post operative orders and discharge orders

  • Among patients completing the protocol there have been no postoperative MI’s



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Next Steps

  • Continue data collection and analysis

  • Identify barriers to successful completion of the protocol and implement solutions to resolve

  • Reminders for postoperative and discharge orders

  • Determine effectiveness of patient screening

  • Revise protocol as needed

  • Expand pilot to other surgical services


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