Quality Improvement Initiatives

Quality Improvement Initiatives

•National Service Framework for Coronary Heart Disease-UK

•Cooperative Cardiovascular Project (CCP)-USA

•National Registry of Myocardial Infarction (NRMI)-US

•Berlin Myocardial Infarction Registry-Germany

Quality Improvement Initiatives

•Global Registry of Acute Coronary Events (GRACE)

•Improving Cardiovascular Outcomes in Nova Scotia (ICONS)-Canada

•Alberta Provincial Project for Outcome Assessment in Coronary heart Disease

database (APPROACH)-Canada•Enhanced Feedback for Effective Cardiac

Treatment (EFFECT)-Canada

0

20

30

40

TeachingHospital

CommunityHospital

SmallHospital

Tim

e (m

inut

es)

Door-to-Needle time for thrombolytic therapy

Benchmark 30 min

38 min 37 min 40 min

Ontario average = 37 min 12/44 hospitals met benchmark

EFFECT STUDY

Type of physician caring for heart attack patients

0

20

40

60

80

100

Perc

ent

Cardiologist General Internist

Family Physician

32%

34% 30%

EFFECT STUDY

4% are Other

Door-to-Needle Time

¨Was 11 minutes less when Emergency physician made decision to administer thrombolytic therapy

¨Was 10 minutes less when thrombolytic therapy was administered in Emergency Department rather than in

CCU/ICU