J Clin Outcomes Manage
Quality of care for non-ST-segment elevation acute coronary syndromes; what should be the status quo?
Lytle BL, Fraulo ES, Peterson ED
Coronary artery disease causes more than 750,000 deaths each year. Certain processes of care (eg, early risk stratification) and interventions (eg, initiation of b-blocker therapy) have been shown to improve outcomes in patients who present with an acute coronary syndrome (ACS). Clinical practice guidelines that delineate an evidence-based approach to caring for these patients are available, but actual clinical practice often deviates significantly from guideline recommendations. This article reviews the American College of Cardiology/American Heart Association guidelines for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction in the context of a patient without classic ACS symptoms and discusses quality improvement steps that can be taken to increase adherence to clinical guidelines. Educational Objectives 1. To describe the recommended timeline and algorithm for evaluating a patient with non–ST-segment elevation acute coronary syndrome (NSTE ACS) 2. To specify an evidence-based approach to acute and discharge therapies for NSTE ACS based on patients’ risk profile and concomitant illness 3. Recognize the frequency of medical errors of commission and omission in community practice 4. To apply the concepts of continuous quality improvement as it applies to NTSE ACS management 5. Understand how clinical practice guidelines can be incorporated into daily medical practice
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