Quality control and improvement in the patient with acute myocardial infarction. Implementation of a quality assurance program

Introduction and objectives. Hospital care of patients with acute myocardia l infarction involves a series of therapeutic measures and risk stratificat ion which are a must since their efficacy has been clearly demonstrated. Th e aim of this study was to develop an internal program to guarantee and imp rove the quality of hospital care to acute myocardial infarction patients. Methods. A medical audit was carried out for evaluation. Seven evaluation c riteria considered as class I by the guidelines on the management of acute myocardia[ infarction patients were analyzed in the discharge report of 163 consecutive patients. Following analysis of the results corrective measure s were implemented. In the second phase reevaluation of 40 patients was per formed to determine the efficacy of the adopted measures. Results. Following the first evaluation the use of AAS, IECAS and beta-bloc kers was found to be correctly indicated in 95, 80 and 72% of the patients, respectively. A strategy of the adequate stratification of risk was carrie d out and ventricular function was evaluated in 93 and 96% of the cases. Co rrect hypolipemia treatment was indicated in 54% of the cases with an adequ ate diet being prescribed in 100%. Three months after the intervention, 40 new patients were evaluated with all the criteria analyzed being fulfilled in 100% of the cases. Conclusions. The use of evaluation techniques and improvement in the qualit y of health care provided to cases of acute myocardial infarction allows th e determination of the care undertaken and its correction if necessary in o rder to follow the guidelines recommended for the care of these patients.