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

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 proacrively investigate their evidence-based clinical standards and outcomes.