Which is a JC heart attack accountability measure?

• A. Beta-blocker at discharge
• B. ACEI or ARB at discharge
• C. Fibrinolytic within 30 minutes
• D. Aspirin on arrival

Answer: (D)

Joint Commission heart attack accountability measures focus on actions that are started promptly and have proven impact on outcomes. Giving aspirin right when a patient with acute coronary syndrome arrives is a standout measure because it reflects immediate, guideline-based care that applies to most patients with a heart attack. Aspirin early in the course of treatment has a well-established mortality benefit and is feasible to verify from the initial medical record, making it a reliable indicator of how quickly and appropriately a hospital initiates therapy.

The other options are important parts of long-term or condition-specific care but aren’t as universally applicable as an arrival-time intervention. Beta-blockers or ACE inhibitors/ARBs at discharge depend on patient stability and left ventricular function and are assessed at discharge rather than on arrival. Fibrinolysis within 30 minutes is highly relevant for STEMI patients treated with fibrinolytics, but not all heart attack patients receive fibrinolysis, making it a less universal arrival-focused measure.