[Quality control and improvement of the care provided to the patient with acute myocardial infarction. Implementation of a quality assurance program].
OBJECTIVE
Hospital care of patients with acute myocardial infarction involves a series of therapeutic measures and risk stratification which are a must since their efficacy has been clearly demonstrated. The aim of this study was to develop an internal program to guarantee and improve the quality of hospital care to acute myocardial infarction patients.


METHODS
A medical audit was carried out for evaluation. Seven evaluation criteria considered as class I by the guidelines on the management of acute myocardial infarction patients were analyzed in the discharge report of 163 consecutive patients. Following analysis of the results corrective measures were implemented. In the second phase reevaluation of 40 patients was performed to determine the efficacy of the adopted measures.


RESULTS
Following the first evaluation the use of AAS, IECAS and the beta-blockers was found to be correctly indicated in 95, 80 and 72% of the patients, respectively. A strategy of the adequate stratification of risk was carried out and ventricular function was evaluated in 93 and 96% of the cases. Correct hypolipemia treatment was indicated in 54% of the cases with an adequate diet being prescribed in 100%. Three months after the intervention, 40 new patients were evaluated with all the criteria analyzed being fulfilled in 100% of the cases.


CONCLUSIONS
The use of evaluation techniques and improvement in the quality of health care provided to cases of acute myocardial infarction allows the determination of the care undertaken and its correction if necessary in order to follow the guidelines recommended for the care of these patients.
Cabrera Bueno
F
F
Servicio de Cardiología. Hospital Universitario Virgen de la Victoria. Málaga.
Gómez Doblas
J J
JJ
Ruiz Ruiz
M
M
Jiménez Navarro
M F
MF
Rodríguez Bailón
I
I
Espinosa Caliani
J S
JS
Pérez Lanzac
F J
FJ
Alonso Briales
J H
JH
Galván
E T
ET
D016507:Cardiology Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D017410:Practice Guidelines as Topic; D016730:Program Development; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011786:Quality Control; D018570:Risk Assessment; D013030:Spain