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Making Surgery Safer: Preventing Post Operative Myocardial Infarctions

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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Making Surgery Safer: Preventing Post Operative Myocardial Infarctions

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  1. 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

  2. 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

  3. 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

  4. 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

  5. Perioperative Beta Blocker Protocol

  6. 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

  7. Progress To Date • 48 patients have been enrolled; 41 have completed the protocol • Hypertension is the most common risk factor

  8. 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

  9. Progress To Date

  10. 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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