Clinical Variation in 30 Day Mortality for Acute Myocardial Infarction


To examine clinical variation in 30 Day mortality for patients presenting with Acute Myocardial Infarction to hospitals throughout NSW.


Increased understanding of the factors that contribute to unwarranted clinical variation (UCV) in 30 day mortality for Acute Myocardial Infarction. If UCV is confirmed there may be opportunities to improve the quality of patient care and decrease length of stay, resulting in reduced costs.


This initiative has been developed to obtain a greater understanding of clinical variation and to actively implement strategies, which better manage UCV.

An expert reference group has been established to develop an audit tool that incorporates standard definitions of Acute Myocardial Infarction. The tool will be used to audit medical records at nine hospitals, which have been randomly selected (including metropolitan and rural facilities). The data will be analysed to assess clinical variation at each site and identify gaps in service delivery.  The existing care pathways will be reviewed and new models of care will be implemented to address clinical variation if required.

Ongoing data collection will assist clinicians to refine care processes and implement evidence-based models of care to support improved patient outcomes.  Clinicians and managers will also be consulted regarding the frequency, format and content of public reporting for UCV. This will fulfil short-term service improvement requirements and longer-term performance reporting accountabilities.


In 2012, the Bureau of Health Information (BHI) released its annual performance report, Healthcare in Focus.  The report highlighted clinical variation across the state in 30-day mortality rates for Acute Myocardial Infarction (AMI) and stroke. The ACI has invited LHD Chief Executives to nominate clinicians and managers from local teams to assess the clinical variation at a range of hospitals, in partnership with the ACI.   


Key Dates

June 2014Project due for completion

Pilot Sites

Implementation Sites


Related Initiatives

Further Details

Healthcare in Focus 2012


Bridie Carr
Cardiac Network Manager
02 9464 4620

Daniel Comerford
Director, Acute Care
02 9464 4602

Page Top | Added: 6 November 2013 | Last modified: 6 November 2013

Bridie Carr
Cardiac Network Manager
02 9464 4620