Core Measure Paper: Acute Myocardial Infarction

The Joint Commission (TJC) sets Core Measure requirements for certain common disease processes. The hospitals are expected to follow these requirements in order to meet compliance with The Joint Commission. These core measures are derived from evidence-based practice, they are specific to certain disease processes, and they are specific to certain groups of patients. Core Measures are “best practices to improve patient care” (“Core Measures”; John Hopkins) and are based on evidence derived from research studies. Core Measures evolved to be because common conditions were continuously being treated with different approaches and some patients were suffering from these consequences. With the help of evidence-based practice and research studies, The Joint Commission and The Centers for Medicare and Medicaid Services (CMS) came together to create the Core Measures to be used in hospitals across the United States. This helps to create a standard of care nationwide for common conditions that are seen frequently in hospitals. (“Core Measures”; CMS)

The Joint Commission and The Centers for Medicare and Medicaid Services came up with a list of Core Measures to be followed these include two different categories; inpatient and outpatient. Inpatient involves diseases such as Acute Myocardial Infarction, Stroke, Surgical Care Improvement Project, Heart Failure, VTE, Pneumonia, Global ED, Global Immunizations, Tobacco Cessation, Perinatal care Mom and Baby, and Sepsis. Outpatient involves diseases similar to inpatient including Acute Myocardial Infarction, Chest Pain, Surgery, Pain Management, and Emergency Department wait times. (“Core Measures”; CMS)

The one core measure that I want to focus on is the measure about treating Acute Myocardial Infarction’s in the hospital setting. The treatment for Acute MI’s include aspirin within twenty-four hours of arrival and at discharge. Patients are to be discharged on Angiotensin-Converting Enzyme (ACE) Inhibitors or Angiotensin II Receptor Blockers (ARB) at discharge only if the ejection fraction is less than 40%. Beta Blockers and HMG-CoA reductase inhibitors (statins) are to be given in hospital and at discharge for all patients. These drugs are given to reduce the incidence of an Acute Myocardial Infarction from reoccurring. Patient’s having an Acute Myocardial Infarction are also required to be in the Cath lab getting a cardiac catheterization with dye done within 90 minutes of arrival to the emergency room and if that does not happen, then therapy with thrombolytics is required within 30 minutes of arrival to emergency room. This core measure was created because Acute MI’s are commonly seen in emergency rooms and these patients were receiving different care at different hospitals. These patients were not being treated adequately enough and not in the timely manner that these patient’s so desperately need.

I chose this core measure to write this paper on because I work on the Cardiovascular Intensive Care Unit and I see these patients so frequently that it interests me to get a more in-depth knowledge about the care these patients received upon arrival to our hospital’s emergency room. Most of these patient’s usually present as normal with few health problems and it happens out of nowhere. These patient’s worlds are turned upside down within just a few minutes and they are thrown into a different world where now they must watch what they eat, take medications, and be on constant watch for signs and symptoms of a reoccurring Acute MI.

Core Measures are extremely important when it comes to our patient’s safety and should be used across the board whenever applicable. These core measures have provided our patients with a nationwide standard of care and the best possible outcomes through research and evidence-based practice.