Quality of care of patients hospitalized with acute coronary syndromes. Scott, I. A.; Denaro, C. P.; Flores, J. L.; Bennett, C. J.; Hickey, A. C.; and Mudge, A. M. Internal Medicine Journal, 32(11):502–511, November, 2002.
abstract   bibtex   
BACKGROUND: Measurement and improvement of quality of care is a priority issue in health care. Patients hospitalized with acute coronary syndromes (ACS) constitute a high-risk population whose care, if shown to be suboptimal on the basis of available research evidence, may benefit from quality improvement interventions. AIM: To evaluate the quality of in-hospital care for patients with ACS, using explicit quality indicators. METHODS: Retrospective case note review was undertaken of 397 patients admitted to three teaching hospitals in Brisbane, Queensland, Australia, between 1 October 2000 and 17 April 2001. The main outcome measures were 12 process-of-care quality indicators, calculated as either: (i) the proportion of all patients who received specific interventions or (ii) the proportion of ideal patients who received specific interventions (i.e. patients with clear indications and lacking contraindications). RESULTS: Quality indicators with values above 80% included: (i) patient selection for thrombolysis (100%) and discharge prescription of beta-blockers (84%), (ii) antiplatelet agents (94%) and (iii) lipid-lowering agents (82%). Indicators with values between 50% and 80% included: (i) timely performance of electrocardiogram (ECG) on admission (61%), (ii) early coronary angiography (75%), (iii) measurement of serum lipids (71%) and (iv) discharge prescription of angiotensin-converting-enzyme (ACE) inhibitors (73%). Indicators with values \textless50% included: (i) timely administration of thrombolysis (35%), (ii) non-invasive risk assessment (23%) and (ii) formal in-hospital, and post-hospital cardiac rehabilitation (47% and 7%, respectively). CONCLUSION: There were delays in performing ECG and administering thrombolysis to patients who presented to emergency departments with ACS. Improvement is warranted in use of non-invasive procedures for identifying high-risk patients who may benefit from coronary revascularization as well as use of serum lipid measurements, ACE inhibitors and cardiac rehabilitation.
@article{scott_quality_2002,
	title = {Quality of care of patients hospitalized with acute coronary syndromes},
	volume = {32},
	issn = {1444-0903},
	abstract = {BACKGROUND: Measurement and improvement of quality of care is a priority issue in health care. Patients hospitalized with acute coronary syndromes (ACS) constitute a high-risk population whose care, if shown to be suboptimal on the basis of available research evidence, may benefit from quality improvement interventions.
AIM: To evaluate the quality of in-hospital care for patients with ACS, using explicit quality indicators.
METHODS: Retrospective case note review was undertaken of 397 patients admitted to three teaching hospitals in Brisbane, Queensland, Australia, between 1 October 2000 and 17 April 2001. The main outcome measures were 12 process-of-care quality indicators, calculated as either: (i) the proportion of all patients who received specific interventions or (ii) the proportion of ideal patients who received specific interventions (i.e. patients with clear indications and lacking contraindications).
RESULTS: Quality indicators with values above 80\% included: (i) patient selection for thrombolysis (100\%) and discharge prescription of beta-blockers (84\%), (ii) antiplatelet agents (94\%) and (iii) lipid-lowering agents (82\%). Indicators with values between 50\% and 80\% included: (i) timely performance of electrocardiogram (ECG) on admission (61\%), (ii) early coronary angiography (75\%), (iii) measurement of serum lipids (71\%) and (iv) discharge prescription of angiotensin-converting-enzyme (ACE) inhibitors (73\%). Indicators with values {\textless}50\% included: (i) timely administration of thrombolysis (35\%), (ii) non-invasive risk assessment (23\%) and (ii) formal in-hospital, and post-hospital cardiac rehabilitation (47\% and 7\%, respectively).
CONCLUSION: There were delays in performing ECG and administering thrombolysis to patients who presented to emergency departments with ACS. Improvement is warranted in use of non-invasive procedures for identifying high-risk patients who may benefit from coronary revascularization as well as use of serum lipid measurements, ACE inhibitors and cardiac rehabilitation.},
	language = {eng},
	number = {11},
	journal = {Internal Medicine Journal},
	author = {Scott, I. A. and Denaro, C. P. and Flores, J. L. and Bennett, C. J. and Hickey, A. C. and Mudge, A. M.},
	month = nov,
	year = {2002},
	pmid = {12412932},
	keywords = {Aged, Angina, Unstable, Cardiology Service, Hospital, Female, Hospitalization, Hospitals, Teaching, Humans, Male, Medical Audit, Myocardial Infarction, Practice Guidelines as Topic, Quality Indicators, Health Care, Quality of Health Care, Queensland, Syndrome, Thrombolytic Therapy},
	pages = {502--511}
}
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