AMI Discharge Care Improved: At Regional Health Authority Four Edmundston, N.-B.

Carole Ruest, RN

Who We Are:

• 205 bed hospital • The RHA4 consists of 3 facilities : – Edmundston Regional Hospital – Grand-Falls General Hospital – Hotel-Dieu Saint-Joseph of Saint-Quentin • 6% of admissions thru ED • Population served approx.50,000

Discharge AIM Statements

• ASA ≥ 90 % • Beta blocker ≥ 90 % • ACE inhibitor or ARB ≥ 85 % • Statin ≥ 95 % • Smoking counselling = 100 %

Team Members

• Cardiac rehabilitation nurse • Head nurse assistant – Emergency room – Intensive Care Unit – Department of Medecine • Internist • Family doctor

Change Ideas

• Documentation tools • Same team on site for inpatients and outpatients for smoking cessation counselling • Discharge medication reviewed by member team and data brought to the internist and family doctor

Measures (for the last 2 years)

Criteria Results

ASA at discharge Beta Blocker at discharge ACE Inhibitor or ARB at discharge 100 % Smoking cessation counselling 100 % Statin (since April ’07) 100 % 100 % 100 %

Lessons Learned

• Have a team • Collect data concurrently

• Find a team • Find time • Make people buy-in

Challenges

• Language • Collecting data tool • Clock time not synchronize throughout the hospital • Small number of patients (transfer out)

Next Steps

• Regionalize the strategy • Set up a team for the 2 other facilities • Find a way to make clock time consistant throughout the hospital

Questions?

Thank you!

Contact Information: Carole Ruest Name : Regional Health Authority Four Address : 275, boulevard Hébert, Edmundston (NB) E3V 4E4 Phone/email : 506-739-2719, [email protected]