title: Reducing case fatality from acute myocardial infarction in Cienfuegos, Cuba, 1994-2009.
abstract: Between 1994 and 2009, the Dr Gustavo Aldereguía University Hospital of Cienfuegos, Cuba implemented a series of interventions that reduced acute myocardial infarction case fatality rate from 47% to 15%. These interventions were part of an institutional plan for myocardial infarction included in the hospital's overall quality assurance strategy. Outcomes resulted primarily from organizational changes (from upgrading of the hospital emergency department and provincial emergency system to creation of a comprehensive coronary care unit and a chest pain center); optimizing use of effective drugs (streptokinase, aspirin, ACE inhibitors and beta blockers); adherence to clinical practice guidelines; and continual and participatory evaluation and adjustment.
authors.affiliation: Dr Gustavo Aldereguía Lima University General Hospital (HGAL), Cienfuegos, Cuba. victor.navarro@gal.sld.cu
authors.forename: Víctor René
authors.initials: VR
authors.lastname: Navarro
authors.forename: Arelys
authors.initials: A
authors.lastname: Falcón
authors.forename: Marcos D
authors.initials: MD
authors.lastname: Iraola
authors.forename: Francisco
authors.initials: F
authors.lastname: Valladares
authors.forename: Pedro O
authors.initials: PO
authors.lastname: Ordúñez
mesh_terms: D003191:Comprehensive Health Care; D003462:Cuba / Q000453:epidemiology; D019983:Guideline Adherence; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality*; D009936:Organizational Innovation; D010818:Practice Patterns, Physicians'; D011785:Quality Assurance, Health Care / Q000379:methods*