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Quality Indicators Could Improve Heart Attack Care

Canadian experts agree on 38 in-hospital and out-of-hospital process, outcome and system indicators

TUESDAY, Oct. 21 (HealthDay News) -- A set of indicators related to the quality of care for patients with acute myocardial infarction could help clinicians and hospitals create strategies that improve survival in these patients, according to a review published in the Oct. 21 issue of CMAJ, the Canadian Medical Association Journal.

Jack V. Tu, M.D., Ph.D., of the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada, and a panel of colleagues reviewed and updated a set of indicators of quality of care for patients with acute myocardial infarction that was created in 2003. They reached consensus on 38 quality indicators, including measurements of in-hospital and out-of-hospital process of care, outcome and system indicators.

In-hospital indicators cover issues such as the administration of aspirin and fibrinolytic therapy after hospital arrival and prescription of aspirin, β-blockers, statins and other drugs at discharge; electrocardiogram within 10 minutes after arrival; percutaneous coronary intervention, reperfusion therapy and assessment of left ventricular function; smoking cessation advice; and in-hospital mortality. Out-of-hospital indicators cover factors such as the use of medications after discharge; physician visit within four weeks of discharge; and readmission rates for acute myocardial infarction, congestive heart failure and unstable angina, the report indicates.

"Performance measures are not intended to be an end unto themselves, but rather a critical first step in measuring and improving the care of patients. We suggest that clinicians and hospitals, working collaboratively, use the indicators to measure their performance, assess the results and implement strategies to ensure that every patient with acute myocardial infarction gets the best possible care and outcomes," the authors conclude.

A panel member associated with the project disclosed relationships with several pharmaceutical companies.

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