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学科主题: 临床医学
题名:
Hospital Quality Improvement Initiative for Patients With Acute Coronary Syndromes in China A Cluster Randomized, Controlled Trial
作者: Du, Xin1,3; Gao, Runlin4,5,6; Turnbull, Fiona7; Wu, Yangfeng1,2; Rong, Ye7; Lo, Serigne7; Billot, Laurent7; Hao, Zhixin1; Ranasinghe, Isuru7; Iedema, Rick8; Kong, Lingzhi9; Hu, Dayi10,13; Lin, Shuguang11; Shen, Weifeng12; Huang, Dejia; Yang, Yuejing4,5,6; Ge, Junbo14; Han, Yaling15; Lv, Shuzheng3; Ma, Aiqun16; Gao, Wei17; Patel, Anushka7; CPACS Investigators
关键词: acute coronary syndrome ; clinical pathways
刊名: CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES
发表日期: 2014-03-01
DOI: 10.1161/CIRCOUTCOMES.113.000526
卷: 7, 期:2, 页:217-226
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: ELEVATION MYOCARDIAL-INFARCTION ; HEALTH SYSTEM REFORM ; CLINICAL PATHWAY ; OUTCOMES ; CARE ; ASSOCIATION ; PERFORMANCE ; MANAGEMENT ; PATTERNS
英文摘要:

Background-

Substantial evidence-practice gaps exist in the management of acute coronary syndromes (ACS) in China. Clinical pathways are tools for improving ACS quality of care but have not been rigorously evaluated.

Methods and Results-

Between October 2007 and August 2010, a quality improvement program was conducted in 75 hospitals throughout China with mixed methods evaluation in a cluster randomized, controlled trial. Eligible hospitals were level 2 or level 3 centers routinely admitting > 100 patients with ACS per year. Hospitals were assigned immediate implementation of the American Heart Association/American College of Cardiology guideline based clinical pathways or commencement of the intervention 12 months later. Outcomes were several key performance indicators reflecting the management of ACS. The key performance indicators were measured 12 months after commencement in intervention hospitals and compared with baseline data in control hospitals, using data collected from 50 consecutive patients in each hospital. Pathway implementation was associated with an increased proportion of patients discharged on appropriate medical therapy, with nonsignificant improvements or absence of effects on other key performance indicators.

Conclusions-

Among hospitals in China, the use of a clinical pathway for the treatment of ACS compared with usual care improved secondary prevention treatments, but effectiveness was otherwise limited. An accompanying process evaluation identified several health system barriers to more successful implementation.

Clinical Trial Registration-

URL: http://www.anzctr.org.au/default.aspx. Unique identifier: ACTRN12609000491268.

语种: 英语
项目资助者: Sanofi-Aventis China
WOS记录号: WOS:000332962100004
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/65391
Appears in Collections:北京大学临床研究所_期刊论文

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作者单位: 1.Univ Technol, Ctr Hlth Commun, Sydney, NSW, Australia
2.Minist Hlth, Dept Dis Control & Prevent, Beijing, Peoples R China
3.Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China
4.Shenyang Northern Hosp, Shenyang, Peoples R China
5.Peking Univ, Hosp 3, Beijing 100871, Peoples R China
6.Guangdong Gen Hosp, Med Res Ctr, Guangzhou, Peoples R China
7.West China Hosp, Chengdu, Sichuan, Peoples R China
8.Fudan Univ, Zhongshan Hosp, Shanghai 200433, Peoples R China
9.Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing 100871, Peoples R China
10.Peking Univ, Hlth Sci Ctr, Clin Res Inst, Beijing 100871, Peoples R China
11.Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China
12.Chinese Acad Med Sci, Dept Cardiol, Cardiovasc Inst, Beijing 100730, Peoples R China
13.Chinese Acad Med Sci, Fuwai Hosp, Beijing 100730, Peoples R China
14.Peking Union Med Coll, Beijing 100021, Peoples R China
15.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
16.Shanghai Jiao Tong Univ, Sch Med, Rui Jin Hosp, Shanghai 200030, Peoples R China
17.Xi An Jiao Tong Univ, Affiliated Hosp 1, Xian 710049, Peoples R China

Recommended Citation:
Du, Xin,Gao, Runlin,Turnbull, Fiona,et al. Hospital Quality Improvement Initiative for Patients With Acute Coronary Syndromes in China A Cluster Randomized, Controlled Trial[J]. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES,2014,7(2):217-226.
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