Reports From the Field: Guidelines, protocals can improve heart attack care

Following evidence-based practice guidelines and standardized treatment protocols can improve the quality of care in patients being treated for a heart attack, according to a study in the March 13 Journal of the American Medical Association [Eagle K, et al. Improvements Gained Through Adherence to ACC/AHA Practice Guidelines. JAMA 2002; 287: 1,269-1,276].

During the one-year study, the medical staff at 10 Michigan hospitals used a "tool kit" to help them follow the American College of Cardiology (ACC) Foundation’s Guidelines in Applied Practice (GAP). The tool kit included a condensed version of the ACC/American Heart Association guidelines; standard order sets, a critical pathway for nurses, and take-home materials for patients.

The initiative produced impressive results, according to Kim Eagle, MD, principal investigator. For instance, before implementation of the program, only 65% of heart attack patients received beta-blockers, compared to 74% after the program was begun. Beta-blockers have been shown to reduce the risk of death one year after discharge by 20% to 25%.

"The GAP project provided for greater consistency of care regardless of age or gender and closed the gap of care that existed for elderly and female patients in several areas of care," Eagle says.

For more information, see the ACC web site: www.acc.org/gap/gap.htm.