Are Some Hospitals Less Life-Saving Than Others?

Your chances of surviving a heart attack could be significantly affected by the hospital you get sent to, an Australian research team has discovered. The amount of variation in acute coronary syndrome (ACS) care in A/NZ emergency rooms was found to be alarmingly high, which can impede the delivery of timely and effective care for heart attack sufferers.

Defibrillator picture from Shutterstock

In the Snapshot ACS report, cardiovascular researchers analysed ACS data from 4,398 patients spread across 286 Australian and New Zealand hospitals between 14 and 27 May 2012. They discovered that the level of care delivered and the outcomes for patients varied significant from hospital to hospital.

"Despite national and international evidence-based guidelines, what we found is that whilst there are certainly some pockets of excellence, overall, significant variation in care is all too common, which is likely to be impacting upon patient outcomes,” explained head researcher Professor David Brieger.

Availability and coordination of services were found to be unsatisfactory in some areas of Australia, with smaller hospitals less likely to deliver recommended care compared to major hospital centres. Variations in classification and jurisdiction also played a significant part.

So which hospitals are the worst offenders and which are the most likely to save your life? Unfortunately, the report failed to give any specifics. We spoke to the report's corresponding author Professor Derek Chew, who indicated that specific hospitals would not be made public to protect the personal information of patients in the study.

The report concludes that a focus on integrated clinical service delivery may provide greater translation of evidence to practice and improve ACS outcomes in Australia and New Zealand.

A Snapshot of ACS care in Australia and New Zealand [Medical Journal of Australia]


Comments

    I imagine it would be difficulty for smaller and small rural hospitals to have the equipment and drugs needed on hand that a similar hospital could hold in one of the larger capital cities of Australia. The travel time (hospital to hospital transfer) from these smaller institutions could also contribute to patient death.

      You'd be surprised at how much variance there is within well-stocked, city based hospitals. Anecdotes I hear from my nursing friends often go along the lines of:

      "When I've [temporarily] worked in hospital X, I had to re-learn how to do everything, because they run the lines differently, give different amounts of medications at different rates and for different reasons, have different 'standards' of patient care, and generally it's just like going to another country!"

      Last edited 20/05/13 4:01 pm

    I suspect that Medical centres and Hospitals in remote and small communities will rank low simply because doctors just don't want to go there. We need to give them incentives and make it worth their while, otherwise you will get doctors of a lower degree of competence getting pushed out there.

    Last edited 20/05/13 1:07 pm

    Should the first sentence be "affected" rather than "effected"?

    I'm guessing RNS is a poor performer. Terrible hospital.

    Yes, some major hospitals should be put to shame. My dad was clinically dead for about 6 minutes (sitting on a chair in front of the nurses station) before a nurse passing by noticed something wrong. Before that they thought he was "just asleep" and this was is the Cardio Ward.

    Treatment of ACS does vary, but in serious cases, time is the most critical factor... so what will kill you? Perhaps driving across town to a hospital you perceive as more proficient while bypassing the nearest one which can start therapy soonest.

    Most people with ACS don't have a cardiac arrest, which is when we get the 'paddles' out as pictured in the photo - interestingly, the approach and treatment of cardiac arrest has been substantially standardised thanks to the work of the various national resuscitation councils, so you'll receive similar care for a cardiac arrest in Australia, UK and NZ.

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