The Client
COOS BAY, OREGON
Bay Area has partnered with Registry Partners since the fall of 2015. The 134-bed hospital is a multiservice client of ours, taking advantage of our Trauma, Core Measures, Sepsis, Get With the Guidelines (GWTG), Bariatrics, and Cardiac registry services.
The Problem
Transportation delays and GDMT protocal inconsistencies
A two-year review (2023-2024) of patient records revealed disparities in ST- Segment Elevation Myocardial Infarction (STEMI) care, especially among patients from remote coastal areas. While overall performance scores remain high, specific subgroups consistently missed crucial interventions. Transportation delays caused by rugged terrain and severe weather prevent timely,
evidence-based care. Additionally, inconsistencies in GDMT protocols point to systemic gaps in treatment delivery. These challenges underscore the need to strengthen interfacility communication and streamline processes to ensure equitable, high-quality care for all patients, regardless of geography.
Introduction
We undertook this project to address critical care disparities for STEMI patients in remote coastal areas, where delays in communication and transportation often hinder timely treatment. Motivated by performance gaps and inspired by our hospital’s strong ties to the community, we aimed to enhance interfacility coordination and ensure equitable care delivery for all patients, regardless of location. After review of electronic medical records (EMR) to identify trends in missed pharmacologic therapies such as aspirin, P2Y12 inhibitors, and statins, a multidisciplinary team – including cardiologists, pharmacists, nurses, and quality improvement specialists – was formed to lead this project.
OVER THE LAST 12 MONTHS, OUR ACCURACY FOR
BAY AREA HAS BEEN AT 97.93%.
Results
Improving Interfacility Communication and Transportation Time of Remote Patients
Following the implementation of standardized EMR order sets, pharmacy involvement, and enhanced interfacility communication, we observed a measurable improvement in discharge medication adherence for STEMI patients. The percentage of eligible patients receiving GDMT
at discharge increased from as low as 84.62% to 100%, with high intensity statin and P2Y12-Inhibitors being the most common fallouts (see graphs below). This improvement was most notable among patients from remote areas, where adherence had previously lagged.
Additionally, the Everbridge platform reduced average transport coordination time by 28%, improving time-to-treatment metrics for patients in outlying regions. Collaboration with EMS and remote facilities also led to increased use of STEMI transfer protocols and better alignment with
best-practice guidelines. These outcomes highlight the effectiveness of a multidisciplinary, system-level approach in closing care gaps and improving equity in cardiovascular care delivery. Our average time to primary PCI among transferred patients decreased from 172 minutes for 2022Q3 to 91 minutes for 2024Q2 (see graph below).
Conclusion
Treated 100% of STEMI patients with defect-free care
The analysis of STEMI care at Bay Area Hospital highlighted critical gaps in medication adherence
and timely access, especially for remote patients. The hospital advanced adherence to evidence-
based care through standardized discharge protocols, enhanced patient education, and improved transport coordination. It reached its goal of treating 100% of STEMI patients with defect-free care. Continued commitment to quality improvement and monitoring will be key to sustaining long-term cardiovascular outcomes for all patients.
A multidisciplinary, systems-based approach can significantly reduce care disparities in STEMI
treatment by improving medication adherence, patient education, and timely access to care.
Standardizing processes and engaging providers and patients are essential to achieving equitable,
evidence-based outcomes.
Quality Improvement Initiatives
IMPLEMENTATION
of targeted quality improvement initiatives led to positive changes in care delivery.
ENHANCED EDUCATION SESSIONS
for healthcare providers improved adherence to treatment protocols, particularly regarding medication administration at discharge.
INCREASED EDUCATION
on the National Cardiovascular Data Registry (NCDR) metrics and provided results quarterly to each physician for review.
RELATIONSHIPS
Formed with another facility for our STEMI cases to be reviewed quarterly and provide physician-to-physician feedback.
FEEDBACK FORMS
Sent to remote facilities and admit all STEMI patients. A follow-up call ensures clarity and emphasizes best practice care guidelines.
Value Proposition
This project improved healthcare value by enhancing patient access to evidence-based care and
medication adherence, resulting in better health outcomes. Providers saw increased workflow efficiency with standardized EMR protocols, while payers benefited from reduced readmissions and costs. By aligning suppliers with best practices, we created a cohesive care network, ultimately supporting goals to reduce healthcare disparities and improve cardiovascular outcomes in underserved communities.
Acknowledgements
The Chest Pain Center extends heartfelt thanks to all who supported this project — including the teams at Bay Area Hospital, our partners in care beyond the community, and Registry Partners for their vital role in data collection and analysis.
Methods
Our Multidisciplinary Approach
We employed a multidisciplinary approach to identify care gaps, implement targeted interventions, and improve outcomes for STEMI patients, particularly those from underserved and remote populations. We launched structured, evidence-based interventions focused on improving STEMI patient outcomes including:
- Standardizing discharge protocols based on current ACC guidelines.
- Implementing EMR order sets to prompt providers to prescribe essential medications automatically.
- Targeting provider education around guideline-based pharmacotherapy and addressing variability in prescribing habits.
- Increasing pharmacy involvement at discharge to ensure medication reconciliation and patient education.
- Implemented use of Everbridge platform to increase accuracy and timeliness of interfacility communication.
- We also identified and addressed common barriers such as affordability, side effect concerns, and limited patient understanding of the importance of dual antiplatelet therapy and statin use. This comprehensive strategy aimed to improve consistency in care and reduce preventable readmissions.
Learn more about how we can help you!
KATIE MEARS
Client Services Representative
katiemears@registrypartners.com
336-675-2230