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Quality Improvement Initiatives. Quality Improvement Initiatives. National Service Framework for Coronary Heart Disease-UK Cooperative Cardiovascular Project (CCP)-USA National Registry of Myocardial Infarction (NRMI)-US Berlin Myocardial Infarction Registry-Germany.
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Quality Improvement Initiatives • National Service Framework for Coronary Heart Disease-UK • Cooperative Cardiovascular Project (CCP)-USA • National Registry of Myocardial Infarction (NRMI)-US • Berlin Myocardial Infarction Registry-Germany
Quality Improvement Initiatives • Global Registry of Acute Coronary Events (GRACE) • Improving Cardiovascular Outcomes in Nova Scotia (ICONS)-Canada • Alberta Provincial Project for Outcome Assessment in Coronary heart Disease database (APPROACH)-Canada • Enhanced Feedback for Effective Cardiac Treatment (EFFECT)-Canada
Benchmark 30 min EFFECT STUDY Door-to-Needle time for thrombolytic therapy 40 min 38 min 37 min 40 30 Time (minutes) 20 0 Teaching Hospital Community Hospital Small Hospital Ontario average = 37 min 12/44 hospitals met benchmark
EFFECT STUDY Type of physician caring for heart attack patients 100 80 60 Percent 40 20 32% 34% 30% 0 Family Physician Cardiologist General Internist 4% are Other
Door-to-Needle Time • Was 11 minutes less when Emergency physician made decision to administer thrombolytic therapy • Was 10 minutes less when thrombolytic therapy was administered in Emergency Department rather than in CCU/ICU