There was a large amount of variation in hospital performance within states. Florida, for example, had areas that were in the top and bottom fifth performance percentage for deaths and readmissions. Whether a hospital was rural or urban, large or small, or had a teaching component often had little impact on the data.
"For those facilities looking for answers [on how to improve], take the path of least resistance and look at what exists," said Dr. Clyde Yancy, president of the American Heart Association and medical director of the Baylor Heart and Vascular Institute in Dallas.
Guidelines for treating heart disease, like those developed by the AHA and the American Stroke Association, can be the easiest and best way to provide care that can potentially prevent deaths or hospital readmission and studies have shown that utilizing such guidelines can improve patient outcomes.
"Any kind of hospital could be good, and that points to things we're not measuring," Krumholz said.
Krumholz added those things could include hospital culture, leadership and the approach to care.
"As long as [these factors] are invisible, they are easy to ignore," Krumholz said. "We hope this will engender a lot of conversation about differences -- why they exist, underlying causes -- and how to get lagging hospitals to perform as well as the performing hospitals.