Permission has been obtained from all persons named in the Acknowledgements.
Management of Acute Coronary Syndromes at Hospital Discharge: Do Targeted Educational Interventions Improve Practice Quality?
Article first published online: 1 MAR 2011
© 2011 National Association for Healthcare Quality
Journal for Healthcare Quality
Volume 34, Issue 1, pages 26–34, January / February 2012
How to Cite
Peterson, G. M., Thompson, A., Pulver, L. K., Robertson, M. B., Brieger, D., Wai, A. and Tett for the DMACS Project Group, S. E. (2012), Management of Acute Coronary Syndromes at Hospital Discharge: Do Targeted Educational Interventions Improve Practice Quality?. Journal for Healthcare Quality, 34: 26–34. doi: 10.1111/j.1945-1474.2011.00137.x
- Issue published online: 13 JAN 2012
- Article first published online: 1 MAR 2011
- the National Prescribing Service (NPS)
- acute coronary syndromes;
- continuum of care;
- quality improvement;
Evidence-based guidelines exist for the management of patients with acute coronary syndromes (ACS), yet adherence is suboptimal. The Discharge Management of Acute Coronary Syndrome project used a quality improvement approach, with targeted intervention strategies to optimize: prescription of guideline-recommended medications; education regarding lifestyle modifications, including cardiac rehabilitation (CR); and communication between hospital staff, patients, and general practitioners. Hospitals across Australia participated in a quality improvement cycle of audit, feedback, intervention, and reaudit. Interventions involved educational meetings, academic detailing and point-of-care reminders, and feedback of baseline audit results. Outcome measures included prescription of guideline-recommended medications, referral to CR, and documentation and communication of management plan. At baseline, 49 hospitals recruited 1,545 patients, and postintervention, 45 hospitals remained active in the project and recruited 1,589 patients. Three thousand and thirty-four hospital staff attended group education or academic detailing sessions. Postintervention, there was a significant increase in the prescription of all four guideline-recommended medications (69% vs. 57%; p<.0001); short-acting nitrates (68% vs. 56%; p<.0001); and documented referral to CR (68% vs. 57%; p<.0001). There were significant increases in documented discharge medication counselling, smoking cessation counselling, and communication of management plans. Targeted educational interventions used as part of a quality improvement cycle can enhance adherence to evidence-based guidelines for the management of patients with ACS.