Interorganizational Collaboration in Emergency Cardiovascular Care. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Langabeer, James R.; Champagne-Langabeer, Tiffany; Helton, Jeffrey R.; Segrest, Wendy; Kash, Bita; DelliFraine, Jami; Fowler, Raymond
• Is Part Of: Quality management in health care. Volume 26:Issue 1(2017)
• Publication Date: 2017-01
• Subjects: interorganizational collaboration -- population health -- quality improvement -- system of care; Medical care -- Quality control -- Periodicals; Total quality management -- Periodicals; Health services administration -- Periodicals; 362.1068
• DOI: 10.1097/QMH.0000000000000120
• Languages: English
• ISSNs: 1063-8628

Abstract

Abstract : Background: Interorganizational collaboration management theory contends that cooperation between distinct but related organizations can yield innovation and competitive advantage to the participating organization. Yet, it is unclear if a multi-institutional collaborative can improve quality outcomes across communities. Methods: We developed a large regional collaborative network of 15 hospitals and 24 emergency medical service agencies surrounding Dallas, Texas, and collected patient-level data on treatment times for acute myocardial infarctions. Using a pre-/posttest research design, we applied median tests of differences to explore outcome changes between groups and over the 6-year period, using data extracted from participating hospital electronic health records. Results: We analyzed temporal trends and changes in treatment times for 2302 patients with ST-elevation myocardial infarction between the pre- and posttest groups. We found a statistically significant 19-minute median reduction in the key outcome metric (total ischemic time, the time difference between the patient's first reported symptoms and the definitive opening of the artery). This represents a 10.8% community-wide improvement over time. Conclusions: Interorganizational collaboration focused on quality improvement can impact population health across a community. This study provides a basis for broader understanding and participation by health care organizations in multi-institutional community change efforts.