QUALITY IMPROVEMENT AT THE NATIONAL LEVEL - LESSONS FROM THE COOPERATIVE CARDIOVASCULAR PROJECT

Most quality improvement projects address care delivered in one servic e of a hospital, such as the operating suite or the obstetrics service . Some projects are collaborative efforts involving groups of hospital s with similar interests. Few projects attempt to change care on a pop ulation basis (i.e., involving all providers in entire stares or the n ation as a whole.) The Cooperative Cardiovascular Project (CCP), spons ored by the Health Care Financing Administration is attempting to impr ove care for all Medicare patients suffering from acute myocardial inf arctions nationwide. The CCP has been active since 1993 and, in a pilo t 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 experie nce.