Sökning: onr:"swepub:oai:DiVA.org:uu-161056" > Cluster-randomized ...
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000 | 03319naa a2200385 4500 | |
001 | oai:DiVA.org:uu-161056 | |
003 | SwePub | |
008 | 111107s2011 | |||||||||||000 ||eng| | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-1610562 URI |
024 | 7 | a https://doi.org/10.1016/j.ahj.2011.07.0272 DOI |
040 | a (SwePub)uu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Flather, Marcus D.4 aut |
245 | 1 0 | a Cluster-randomized trial to evaluate the effects of a quality improvement program on management of non-ST-elevation acute coronary syndromes :b The European Quality Improvement Programme for Acute Coronary Syndromes (EQUIP-ACS) |
264 | 1 | b Elsevier BV,c 2011 |
338 | a print2 rdacarrier | |
520 | a Background Registries have shown that quality of care for acute coronary syndromes (ACS) often falls below the standards recommended in professional guidelines. Quality improvement (QI) is a strategy to improve standards of clinical care for patients, but the efficacy of QI for ACS has not been tested in randomized trials. Methods We undertook a prospective, cluster-randomized, multicenter, multinational study to evaluate the efficacy of a QI program for ACS. Participating centers collected data on consecutive admissions for non-ST-elevation ACS for 4 months before the QI intervention and 3 months after. Thirty-eight hospitals in France, Italy, Poland, Spain, and the United Kingdom were randomized to receive the QI program or not, 19 in each group. We measured 8 in-hospital quality indicators (risk stratification, coronary angiography, anticoagulation, beta-blockers, statins, angiotensin-converting enzyme inhibitors, and clopidogrel loading and maintenance) before and after the intervention and compared composite changes between the QI and non-QI groups. Results A total of 2604 patients were enrolled. The absolute overall change in use of quality indicators in the QI group was 8.5% compared with 0.8% in the non-QI group (odds ratio for achieving a quality indicator in QI versus non-QI 1.66, 95% CI 1.43-1.94; P < .001). The main changes were observed in the use of risk stratification and clopidogrel loading dose. Conclusions The QI strategy resulted in a significant improvement in the quality indicators measured. This type of QI intervention can lead to useful changes in health care practice for ACS in a wide range of settings. | |
700 | 1 | a Babalis, Daphne4 aut |
700 | 1 | a Booth, Jean4 aut |
700 | 1 | a Bardaji, Alfredo4 aut |
700 | 1 | a Machecourt, Jacques4 aut |
700 | 1 | a Opolski, Grzegorz4 aut |
700 | 1 | a Ottani, Filippo4 aut |
700 | 1 | a Bueno, Hector4 aut |
700 | 1 | a Banya, Winston4 aut |
700 | 1 | a Brady, Anthony R.4 aut |
700 | 1 | a Bojestig, Mats4 aut |
700 | 1 | a Lindahl, Bertilu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper4 aut0 (Swepub:uu)belin227 |
710 | 2 | a Uppsala universitetb Uppsala kliniska forskningscentrum (UCR)4 org |
773 | 0 | t American Heart Journald : Elsevier BVg 162:4, s. 700-707.e1q 162:4<700-707.e1x 0002-8703x 1097-6744 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-161056 |
856 | 4 8 | u https://doi.org/10.1016/j.ahj.2011.07.027 |
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