title: Monitoring guideline adherence in the management of acute coronary syndrome in hospitals: design of a multicentre study.
abstract: BACKGROUND
  Increasing guideline adherence in the management of acute coronary syndrome (ACS) in hospitals potentially reduces heart failure and mortality. Therefore, an expert panel identified three guideline recommendations as the most important aims for improvement in ACS care, i.e. timely invasive treatment, use of risk scoring instruments and prescription of secondary prevention medication at discharge.
  
  
  OBJECTIVE
  This study aims to evaluate in-hospital guideline adherence in the care of patients diagnosed with ACS and to identify associated factors.
  
  
  METHODS
  The study has a cross-sectional design. Data are collected in 13 hospitals in the Netherlands by means of retrospective chart review of patients discharged in 2012 with a diagnosis of ACS. The primary outcomes will be the percentages of patients receiving timely invasive treatment, with a documented cardiac risk score, and with a prescription of the guideline-recommended discharge medication. In addition, factors associated with guideline adherence will be studied using generalised linear (mixed) models.
  
  
  CONCLUSIONS
  This study explores guideline adherence in Dutch hospitals in the management of patients diagnosed with ACS, using a data source universally available in hospitals. The results of this study can be informative for professionals involved in ACS care as they facilitate targeted improvement efforts.
authors: Department of Public and Occupational Health - EMGO+Institute/VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands, j.tra@vumc.nl.
authors: J
authors: J
authors: Tra
authors: J
authors: J
authors: Engel
authors: I
authors: I
authors: van der Wulp
authors: M C
authors: MC
authors: de Bruijne
authors: C
authors: C
authors: Wagner