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July 13, 2004International Journal for Quality in Health CareOpen Access

Optimising care of acute coronary syndromes in three Australian hospitals

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Why the study?

Does a multifaceted quality improvement program improve care processes and guideline adherence in patients hospitalized with acute coronary syndromes?

Population

1,594 consecutive patients admitted to hospital with acute coronary syndrome, mean age 68 years, 65% male…

Comparison

Multifaceted quality improvement program… vs Baseline care.

Design

Cohort

Key result

A multifaceted quality improvement program significantly increased the proportion of acute coronary syndrome patients undergoing timely ECG (70% vs 61%; P=0.04) and receiving evidence-based therapies.

Authors

ISIan Scott

Discussion

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Overview

Supports QI programs for ACS process improvement in observational settings; leaves open randomized confirmation of outcome benefits.

Study Design

Type

Observational (n=1,594)

Multicenter

Yes

Structured PICO

Does a multifaceted quality improvement program improve care processes and guideline adherence in patients hospitalized with acute coronary syndromes?

P
Population
1,594 consecutive patients admitted to three teaching hospitals with acute coronary syndrome.
I
Intervention
Multifaceted quality improvement program including clinical guidelines, reminder tools, educational interventions, 6-monthly performance feedback, pharmacist-mediated patient education program, and facilitation of multidisciplinary review of work practices.
C
Comparator
Baseline care (patients admitted before the intervention, between October 1, 2000 and April 16, 2001).
O
Outcome
Changes in key quality indicators relating to timing of electrocardiogram (ECG) and thrombolysis in emergency departments, serum lipid measurement, prescription of adjunctive drugs, and secondary prevention.

Main Result

Absolute Event Rate: 70% vs 61%

p-value: p=0.04

A multifaceted quality improvement program significantly improves adherence to evidence-based care processes and secondary prevention prescribing for patients hospitalized with acute coronary syndromes.

Cite This Study

Ian Scott (2004) conducted an observational in Acute coronary syndromes (n=1,594). Multifaceted quality improvement program vs. Baseline care (pre-intervention) was evaluated on Proportion of eligible patients undergoing timely ECG (p=0.04). A multifaceted quality improvement program significantly increased the proportion of acute coronary syndrome patients undergoing timely ECG (70% vs 61%; P=0.04) and receiving evidence-based therapies.

synapsesocial.com/papers/6aa897c11aabb93f4abfdefehttps://doi.org/10.1093/intqhc/mzh051
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