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

Abstract

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.

Impact of a Performance Improvement CME activity on the care and treatment of patients with psoriasis

“…Several case studies have demonstrated that education, specifically Performance Improvement (PI) CME, improves clinical practice. [28][29][30][31][32][33][34][35] However, to our knowledge, data do not exist regarding the use of the PI CME format in the specialty of dermatology. PI CME helps physicians evaluate their practice and implement evidencebased strategies to overcome identified gaps, then remeasure their performance after these strategies have been implemented in their practice.…”

Monitoring guideline adherence in the management of acute coronary syndrome in hospitals: design of a multicentre study

“…These efforts increased the likelihood that patients were treated on time with PCI [29], risk scores were documented [30] and the recommended discharge medication was prescribed [31]. Therefore the monitoring of guideline adherence as the foundation for targeted quality improvement efforts seems promising.…”

A Clinician Performance Initiative to Improve Quality of Care for Patients with Osteoporosis

“…The most likely reason for the high rate of attrition was due to the time commitment required of PI CME activities. 29 This is an inherent problem often observed with PI CME activities. 29,30 Interestingly, a study examining the direct effect of PI participation on patient outcomes found minimal, if any, differences between patient outcomes among clinicians who completed various stages of PI.…”

“…29 This is an inherent problem often observed with PI CME activities. 29,30 Interestingly, a study examining the direct effect of PI participation on patient outcomes found minimal, if any, differences between patient outcomes among clinicians who completed various stages of PI. 31 Participation in the process of PI itself contributed to greater differences in patient outcomes as compared with didactic CME activities.…”