The 5 hospital factors that affect heart attack survival

"Our research shows that the key facets to safety and quality in hospitals may not be new gadgets," says Elizabeth Bradley, Ph.D., faculty director at the Yale Global Health Leadership Institute, professor of public health and senior author on the paper. "The essential ingredients are not expensive. If we could implement our findings in more hospitals, we could improve quality without adding to costs."

Staff in the best hospitals reported strong communication and coordination across disciplines and departments. In low-performing hospitals, sporadic involvement of senior management was common, in part due to frequent turnover, and management did not create an environment that encouraged taking responsibility for performance problems. Curry says that achieving high performance may require long-term investment and concerted efforts to create an organizational culture that supports full engagement in quality, strong communication and coordination among groups, and capacity for problem solving and learning across the organization.

"What we found was that the best hospitals were distinguished by a combination of factors that related to how they organized and managed the care and the performance of the teams," says Harlan Krumholz, M.D., professor of medicine and cardiology at Yale School of Medicine. "This study begins to address our need to know what it takes to be an outstanding performer."

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The study was funded by the Agency for Healthcare Research and Quality, the Commonwealth Fund, and the United Fund.

The Global Health Leadership Institute supports health leaders to improve the performance of health systems through leadership development, quality improvement programs, and health systems research. For more information on the AMI study or GHLI, contact: Rosalind D'Eugenio, (203) 436-3649, rosalind.deugenio@yale.edu.

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