Heart Attack (Acute Myocardial Infarction - AMI)

A heart attack (also called an acute myocardial infarction or AMI) occurs when the arteries that supply oxygen and nutrients to the heart become blocked and the blood supply is slowed or stopped. The result is that the part of the heart muscle that is fed by the blocked arteries may be damaged or destroyed.

Most patients who go to the hospital with heart attack or chest pain are treated first in the hospital's Emergency Department (often called the ER) and are then admitted to the hospital as inpatients.

At the University of Michigan Health System, we evaluate our performance in caring for heart attack patients by measuring the extent to which we follow best practices and achieve the best results. We have met and often exceeded our quality goals for care that we deliver in the Emergency Department and in the inpatient (hospital) settings.

The following graphs describe the performance of the University of Michigan Health System by measuring the extent to which we follow best practices when treating patients with a heart attack. These best practices are also called evidence-based processes of care. When followed, they lead to better outcomes.

Medication Use - Aspirin at Arrival
Higher Value = Better Performance

Details

Why is This Measure Important?

A heart attack is caused by blockages in the arteries that supply oxygen and nutrients to the heart. The blockages can be caused by blood clots. Aspirin can prevent blood clots from forming. Chewing an aspirin as soon as symptoms of a heart attack begin may help reduce the severity of the attack. This chart shows the percent of heart attack patients who were given (or took) aspirin within 24 hours of arrival at the hospital.

How is UMHS Performing?

The University of Michigan Health System achieved a perfect 100% rate in almost every quarter during the last two years; all eligible heart attack patients were prescribed aspirin within 24 hours of arrival at our hospital.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from the Joint Commission.

Medication Use Ace Inhibitor and ARB
Higher Value = Better Performance

Details

Why is This Measure Important?

Most heart failure patients and heart attack patients who have decreased heart function should be prescribed ACE inhibitors or ARBs before being discharged from the hospital. Treatment with these medications can reduce the risk of death from future heart attacks. Patients with heart failure typically suffer from decreased function of the left side of the heart, also known as left ventricular systolic dysfunction (LVSD), and are prescribed medications to make it easier for the heart to pump blood. ACE (angiotensin-converting enzyme) inhibitors widen blood vessels, easing blood flow and decreasing the workload on the heart. ARBs (angiotensin II receptor blockers) serve as an alternative for people who cannot tolerate ACE inhibitors.

How is UMHS Performing?

The University of Michigan Health System had achieved a perfect 100%. All patients were prescribed either an ACEI inhibitor or an ARB before discharge from the hospital.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from the Joint Commission.

Medication Use - Aspirin Prescribed
Higher Value = Better Performance

Details

Why is This Measure Important?

A heart attack is caused by blockages in the arteries that supply oxygen and nutrients to the heart. The blockages can be caused by blood clots. Aspirin can help prevent blood clots from forming or help dissolve blood clots that have formed. Continued use of aspirin may help reduce the risk of another heart attack. Because aspirin can have side effects like stomach inflammation, bleeding, or allergic reactions, talk to your health care provider before using aspirin on a regular basis to make sure it is safe for you.

How is UMHS Performing?

The University of Michigan Health System achieves a better than 99% rate in almost every quarter during the last two years; all eligible heart attack patients were prescribed aspirin before being discharged from our hospital.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

Medication Use Choloesterol Lowering MedicationsPrescribed
Higher Value = Better Performance

Details

Why is This Measure Important?

Statin medication should be prescribed for patients who were treated for a heart attack. This medication helps to lower cholesterol and is effective in lowering the risk of death or another heart attack. This measure shows the percentage of patients who had a heart attack and received a prescription for a statin before discharge from the hospital. A higher percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System is at or better than the national average. Most patients were prescribed a statin medication on discharge.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

Medication Use - Beta Blocker Prescribed
Higher Value = Better Performance

Details

Why is This Measure Important?

Beta blocker medication should be prescribed for patients who were treated for a heart attack before they leave the hospital. This medication helps lower blood pressure, treat chest pain (angina) and heart failure, and prevent a future heart attack. Beta blockers relieve the stress on your heart by slowing the heart rate and reducing the force with which your heart muscles contract to pump blood.

How is UMHS Performing?

The University of Michigan Health System is at or better than the national average. Most patients were prescribed a beta blocker before hospital discharge.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from the Joint Commission.

Angioplasty or Stent w/in 90 Minutes
Higher Value = Better Performance

Details

Why is This Measure Important?

A heart attack is caused by blockages in the arteries that supply oxygen and nutrients to the heart. The blockages can be caused by blood clots. Angioplasty and/or stents are procedures to open blocked arteries. These procedures involve a catheter (a flexible tube) that is inserted, often through your leg, and guided through the blood vessels to the blockage. Angioplasty is the process of inserting and inflating a balloon to open the blocked artery. Stents are placed in the artery to hold it open. These procedures must be done as quickly as possible to lessen the damage to the heart muscle and increase the patient's chances of survival.

How is UMHS Performing?

The University of Michigan Health System performance in providing rapid treatment for heart attack patients is mostly above the national average.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

In this section, we evaluate outcomes following treatment of patients with a heart attack by measuring patient survival rates and re-hospitalization rates. We compare our rates to the national average, provided by the Centers for Medicare and Medicaid Services (CMS). The risk of death and re-hospitalization depends on many factors, including the patient's health condition. The risk of the patients we treat may be greater than the risk of patients represented in the CMS average, because the University of Michigan Health System treats many complex patients who have heart disease and other serious medical problems. However, as the graphs below show, UMHS is successful in managing these complex cases. In both graphs, when our rates appear in the green bar, our performance is no different from the national average.

Heart Attack Survival

Details

Why is This Measure Important?

This measure evaluates the survival of heart attack patients who are insured by Medicare and hospitalized at the University of Michigan Health System. Medicare produces and reports this rate for hospitals across the country. To help you compare performance of the University of Michigan to hospitals nationally, Medicare adjusts the rates to try to correct for differences in the severity of illness of patients treated at different hospitals.

How is UMHS Performing?

Heart attack patients who receive treatment at the University of Michigan Health System have a survival rate that is no different from the national average.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.

Heart Attack Re-Hospitalization

Details

Why is This Measure Important?

This measure is defined as the percentage of patients insured by Medicare who were discharged from our hospital following treatment of heart attack and were then re-hospitalized within 30 days. This measure evaluates several aspects of care: the quality of care during the first hospitalization and the effectiveness of our efforts to educate patients about managing their disease and to coordinate care with the patients' outpatient physicians. Our goal is to address the patient's needs while they are in the hospital so that they do not experience problems when they return home.

To help you compare performance of the University of Michigan to hospitals nationally, Medicare adjusts the rates to try to correct for differences in the severity of illness of patients treated at different hospitals.

How is UMHS Performing?

Re-hospitalization rates for heart attack patients at the University of Michigan Health System are the same as the national average. Reaching this goal can be difficult when treating severely ill patients; however, we are working to be even better by improving patient education and coordinating follow-up care with the patient's outpatient physicians.

UMHS Source: Hospital administrative data and chart review.
Comparison Group Source: National average from CMS / Hospital Compare.