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A Report of Quality Improvement in the Care of Patients With Acute Coronary Syndromes

Cannon, Christopher P. MD*; Hoekstra, James W. MD; Larson, David M. MD; Karcher, Rachel Bongiorno PharmD§; Mencia, William A. MD§; Berry, Carolyn A. PhD; Stowell, Stephanie A. MPhil§

Critical Pathways in Cardiology: March 2011 - Volume 10 - Issue 1 - p 29-34
doi: 10.1097/HPC.0b013e318204eb8b
Original Article

Despite the existence and wide acceptance of guidelines for the treatment of patients with acute coronary syndromes, gaps in patient care still remain. To improve clinical processes of acute coronary syndromes care, a performance improvement (PI) continuing medical education (CME) program, a CME format approved by the American Medical Association, was developed. Clinician participants underwent a 3-stage process: (1) an initial patient chart review for self-assessment purposes, (2) the development and implementation of a personalized PI plan focusing on strategies to enhance processes of care, and (3) a second patient chart review to assess the changes in practice. Although participants provided a high baseline level of guideline-recommended care, there was an improvement in the documentation of the use of risk scores and a trend towards improved treatment times including many participants reaching a door-to-needle time of within 30 minutes. Participants were also more likely to measure cardiac biomarkers and document electrocardiogram performance times. These results demonstrate that PI is a valid and effective means of CME that has the potential to positively affect patient outcomes.

From the *Cardiovascular Division, Brigham and Women's Hospital, Boston, MA; †Department of Emergency Medicine, Wake Forest University Health Sciences, Winston-Salem, NC; ‡Department of Emergency Medicine, Ridgeview Medical Center, Minneapolis, MN; §Med-IQ, Baltimore, MD; and ¶Center for Health and Public Service Research, Wagner Graduate School, New York University, New York, NY.

Supported by a sanofi aventis; U.S.

Reprints: Stephanie A. Stowell, MPhil, Med-IQ, 5523 Research Park Drive, Suite 210, Baltimore, MD 21228. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.