Cardiovascular centers of excellence program: a system approach for improving the care and outcomes of cardiovascular patients at HCA hospitals.

Article-at-a-Glance Background A voluntary continuous quality improvement (CQI) effort, the cardiovascular Centers of Excellence (COE) program was implemented by HCA, Inc., to improve cardiovascular care in its hospital system. Methods The cardiovascular COE program targeted 165 hospitals that provide cardiovascular services in at least one major service area. Awards (unrestricted grants) provided hospitals with an incentive to participate. Results One hundred fifty-eight hospitals (95.8%) completed the entire 2005 cardiovascular COE program; five were identified as cardiovascular COE. The program developed three key CQI activities: (1) an ongoing Web-based survey to inventory, track, and verify evidence-based practices across all aspects of patient care, including clinical practices, leadership, communications, patient safety, and patient education; (2) quarterly benchmark reports tracking risk-adjusted outcomes and evidence-based practices; and (3) regularly scheduled educational programs presented by an interdisciplinary team in which lessons learned from an institution's successful, evidence-based, best-practice implementation were discussed. Discussion The COE program successfully encouraged facilities to proactively investigate their evidence-based clinical standards and outcomes.