A rapid-cycle collaborative model to promote guidelines for acute myocardial infarction

Jt Comm J Qual Saf. 2003 Sep;29(9):468-78. doi: 10.1016/s1549-3741(03)29056-0.


Background: This American College of Cardiology (ACC) Acute Myocardial Infarction (AMI) Guidelines Applied in Practice (GAP) collaborative in Michigan represented ACC's third initiative, in partnership with local health care coalitions and the Michigan Peer Review Organization. The GAP Pilot Project formed the basis for this project, which supported caregivers' efforts to improve their processes and consistently apply the evidence-based guidelines for AMI care.

The southeast michigan expansion project: The Institute for Healthcare Improvement (IHI) Breakthrough Series model of improvement was modified to merge the GAP Pilot Project's design with a rapid-cycle quality improvement model. The collaborative included learning sessions that focused on five phases--planning, tool implementation, monitoring tool use, remeasurement, and results--and on increasing tool use rates in each phase.

Conclusions: Building on the work of two previous efforts, the ACC AMI GAP projects yielded substantial collective knowledge. Developing and fostering a collaborative culture allowed hospital teams to avoid barriers or overcome them successfully based on others' experiences and collectively solve problems, and it shortened the learning curve and accelerated QI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Cardiology Service, Hospital / standards*
  • Cooperative Behavior*
  • Guideline Adherence / statistics & numerical data
  • Health Care Coalitions*
  • Humans
  • Management Quality Circles
  • Michigan
  • Models, Organizational*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / therapy*
  • Pilot Projects
  • Practice Guidelines as Topic*
  • Professional Review Organizations
  • Quality Indicators, Health Care
  • Total Quality Management*