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Evaluation & the Health Professions, Vol. 21, No. 4, 525-536 (1998)
DOI: 10.1177/016327879802100410

Quality Improvement at the National Level

Lessons From the Cooperative Cardiovascular Project

Thomas A. Marciniak

Linda Mosedale

Health Care Financing Administration

Edward F. Ellerbeck

University of Kansas Medical Center

Most quality improvement projects address care delivered in one service of a hospital, such as the operating suite or the obstetrics service. Some projects are collaborative efforts involving groups of hospitals with similar interests. Few projects attempt to change care on a population basis (i.e., involving all providers in entire states or the nation as a whole.) The Cooperative Cardiovascular Project (CCP), sponsored by the Health Care Financing Administration, is attempting to improve carefor all Medicare patients suffering from acute myocardial infarctions nation-wide. The CCP has been active since 1993 and, in a pilot project, has demonstrated that care can be improved on a population basis (i.e., in four entire states). This article explores the lessons learned from the CCP pilot and from the evolving CCP national experience.


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