Reducing the Treatment Gap by Raising the Overall Quality of Care

1. Reducing the Treatment Gap by Raising the Overall Quality of Care Using Get With The Guidelines to Reduce Treatment Gaps and Disparity in Health Care Presented by: Mary Paulsen, MSN RN Quality Improvement Director ~ Colorado American Heart Association/American Stroke Association

2. Risk Factors for Disparate Healthcare Poverty Racism Discrimination Bias Language barriers Geographical barriers Socioeconomic status Immigrant status TRUST (or lack thereof)

3. Potential Sources of Disparities in Care Health systems-level factors Financing Structure of care Cultural and linguistic barriers Patient-level factors Patient preferences Refusal of treatment Poor adherence Biological difference

4. Using Guidelines to Decrease Treatment Disparities Goal is not simply equality of care The goal is equality of outstanding care and the best outcomes that can be achieved given our current knowledge, customized to the needs of the individual

5. Get With the Guidelines: A Tool to Close Reduce Healthcare Disparities American Heart Association/American Stroke Association Get With the Guidelines program (CAD/HF/Stroke) is a quality improvement program that promotes the consistency and equity of care through the use of evidence-based guidelines

6. Abstracts:Addressing Disparities Using Get With The Guidelines Program Healthcare Disparities in Acute Intervention for Patients Hospitalized with Ischemic Stroke or TIA in Get With The Guidelines-Stroke  Lee H. Schwamm et al. Background: We sought to determine if disparities in stroke treatment were present in a large sample of hospitalized stroke patients. Conclusions: Disparities exist in acute stroke delivery associated with both patient and hospital characteristics Does Get With The Guidelines - Coronary Artery Disease Reduce Treatment Disparities Among Different Racial and Ethnic Groups? Kenneth A LaBresh,et al Background: Disparities in CAD care based o race and ethnicity (R/E) persist in US hospitals and have not been shown to be reduced by system changes to improve care. Conclusions: Although initial enrollment of patients with noncaucasian R/E has been low and more work is needed in smoking cessation and lipid treatment, GWTG is associated with significant improvement in the treatment gap among R/E groups for hospitalized patients with CAD.

7. Abstracts:Addressing Disparities Using Get With The Guidelines Program The American Heart Association Get with the Guidelines Coronary Artery Disease Program Narrows the Gender Associated Treatment Gap Gray Ellrodt, et al Background: Treatment differnces between men and women with cardiovascular disease have been documented. We hypothesized that the GWTG-CAD program could effectively narrow the gender-related gap. Conclusion: Preliminary observations from GWTG-CAD suggest that a comprehensive hospital-based continuous quality improvement treatment and prevention program can close the gender related treatment gap in secondary prevention within one year.

8. Get With The Guidelines: Proven Tool to Address Healthcare Disparities Get With The Guidelines is proven program that can: Change the way we work Change the way that we communicate Promotes the consistency and equity of care through the use of evidence-based guidelines Measure where we are and measure our progress: many health care providers do not recognize that there are health disparities Among the ones that do believe there is a problem, they do not believe it is an issue within their organization