Table 2 Primary outcome measures, independent variables, and covariates

Primary outcome measures

Shifts in key dimensions of hospital organizational culture measured by annual survey^b

Survey-reported ^b :

• Learning and problem solving

• Psychological safety

• Senior leadership support

• Commitment to the organization

• Stress/pressure in the system

In-depth qualitative interviews

Use of five targeted evidence-based practices associated with lower mortality for patients with AMI, measured by annual survey^a

Survey-reported:

• Monthly meetings between hospital clinicians and EMS to review AMI cases

• Pharmacist rounds on patients with AMI

• Nurses specifically assigned to the cardiac catheterization laboratory

• Both nurse and physician champions

• Clinicians encouraged to creatively solve problems related to AMI care

In-depth qualitative interviews

In-hospital AMI mortality

• Total number of deaths of patients with a principal discharge diagnosis of AMI over a 12-month period

Independent variables

Indicator variables for time period

• Pre/post intervention

Covariates

Indicator variable for intervention or network

• Whether hospital is an intervention hospital, or a peer network hospital

Hospital characteristics

• Multihospital network affiliation

• Geographic region

• Teaching status

• AMI volume