Get With The Guidelines

Get With The Guidelines
Name	Get With The Guidelines
Established	2000s
Founder	American Heart Association
Type	Quality improvement program
Headquarters	Dallas
Parent organization	American Heart Association

Get With The Guidelines is a hospital-based quality improvement program developed by the American Heart Association to improve care for patients with myocardial infarction, stroke, heart failure, and other cardiovascular and cerebrovascular conditions. The initiative partners with hospitals, clinicians, and health systems to implement evidence-based protocols drawn from guidelines by organizations such as the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. The program collects clinical data, provides performance feedback, and supports the adoption of best practices to align hospital care with recommendations from bodies like the National Institutes of Health and the Institute of Medicine.

Overview

Get With The Guidelines is designed as a registry-driven quality improvement and guideline implementation program that links clinical data capture with performance metrics from institutions such as the Joint Commission, the Centers for Medicare & Medicaid Services, and the Agency for Healthcare Research and Quality. Participating hospitals submit patient-level data comparable to registries like the Society of Thoracic Surgeons and National Cardiovascular Data Registry to enable benchmarking against peers such as Mayo Clinic, Cleveland Clinic, Johns Hopkins Hospital, Massachusetts General Hospital, and Stanford Health Care. The program's toolset integrates with electronic health record systems from vendors including Epic Systems, Cerner Corporation, Allscripts, MEDITECH, and McKesson to facilitate quality measurement and reporting for institutions like Mount Sinai Hospital and Children's Hospital of Philadelphia.

History and development

Launched in the early 2000s by the American Heart Association and later expanded through collaborations with the American Stroke Association, the program evolved alongside national efforts such as the Healthy People initiatives and policy developments led by the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. Early adopters included academic centers affiliated with Harvard Medical School, Columbia University Irving Medical Center, and University of Pennsylvania Health System, while subsequent spread reached integrated networks like Kaiser Permanente and community systems such as HCA Healthcare and Community Health Systems. The initiative incorporated evolving guideline recommendations from panels convened by the American Heart Association and the American College of Cardiology Foundation, following evidence syntheses similar to those produced by the Cochrane Collaboration and the U.S. Preventive Services Task Force.

Program components and protocols

Core components include condition-specific registries for acute myocardial infarction, ischemic stroke, heart failure, and cardiac arrest, along with performance measures mapped to guideline statements from the American Heart Association, the American College of Cardiology, and specialty societies like the American Academy of Neurology and the Heart Failure Society of America. Protocols emphasize timely interventions such as reperfusion therapy with guidance referenced to trials and guidelines from entities like the European Society of Cardiology, the National Stroke Association, and publications in journals such as the New England Journal of Medicine, The Lancet, and the Journal of the American Medical Association. Implementation tools include checklists, order sets, education modules, and dashboards compatible with health IT platforms and compliance frameworks like those of the Joint Commission and Centers for Medicare & Medicaid Services quality reporting programs.

Impact and outcomes

Published analyses and registry reports have associated participation with improvements in process measures and outcomes reported by academic centers including Yale New Haven Hospital, Brigham and Women's Hospital, and University of Michigan Health System, as well as regional systems such as Geisinger Health System and Intermountain Healthcare. Studies in peer-reviewed outlets including Circulation, Stroke (journal), and Annals of Internal Medicine have documented increases in guideline-concordant therapies, reductions in door-to-needle and door-to-balloon times, and improvements in in-hospital mortality and complication rates. The program has informed policy discussions involving the Centers for Disease Control and Prevention, the National Quality Forum, and payer initiatives from organizations like Aetna and UnitedHealth Group that tie reimbursement to quality metrics.

Participation and implementation

Hospitals and health systems from across the United States, including academic medical centers like UCSF Medical Center and community hospitals within networks such as Ascension Health and Providence Health & Services, enroll in registries and use performance feedback to drive local quality projects. Implementation strategies draw on quality improvement methods associated with figures and institutions like Deming, the Institute for Healthcare Improvement, Don Berwick, and programs such as LEAN manufacturing and Six Sigma adapted for clinical care. Data submission and benchmarking enable comparison with national leaders including Cleveland Clinic and regional collaboratives such as the American Hospital Association networks and state hospital associations.

Criticisms and limitations

Critiques note that registry-based programs can face challenges similar to other large-scale initiatives overseen by bodies like the Institute of Medicine and the Government Accountability Office, including selection bias among participating institutions, variability in data quality like that documented in registries such as the National Surgical Quality Improvement Program, and potential misalignment with local priorities in systems such as CMS value-based programs. Additional concerns raised by scholars at institutions like Harvard, Yale, and UCLA include the administrative burden on clinical staff, interoperability hurdles with vendors such as Epic Systems and Cerner Corporation, and the difficulty of attributing outcome changes solely to participation given concurrent interventions by payers like Centers for Medicare & Medicaid Services and public health campaigns by the Centers for Disease Control and Prevention.

Category:Cardiology Category:Quality improvement programs