KOCHI: In a bid to improve the quality of cardiac care, Cardiological Society of India (Kerala Chapter) recently carried out the largest randomised trial in cardiovascular medicine in the country.
The study and report titled ‘Acute Coronary Syndrome Quality Improvement in Kerala (ACS QUIK)’ has been published after peer review in the Journal of the American Medical Association (JAMA). According to its findings, a simple tool kit of checklists, audit feedback reporting and education materials improved the quality of care for Acute Coronary Syndrome in Kerala.
As part of the efforts to remedy and improve heart attack care, the new study ACS QUIK had recruited 21,374 patients from 63 hospitals between 2014-2016. In ACS QUIK, the hospitals were first assigned to deliver usual care, but were then randomly assigned to implement a quality improvement toolkit which included audit and feedback reporting, checklists, patient education materials and linkage to emergency cardiovascular care training. All hospitals eventually received the toolkit intervention.
This simple toolkit improved the quality of care among hospitals which received it. Major adverse cardiovascular events in the intervention group were found to be 5.3 per cent whereas the usual care group recorded 6.4 per cent. Similarly, the rate of 30-day deaths was 3.9 per cent in the intervention group compared to 5.1 per cent in the control group.
While the study did not demonstrate a drastic reduction in the rate of death, stroke, recurrent heart attack or major bleeding at 30 days, the toolkit showed a high potential to improve the quality and safety of care and outcomes of heart attacks and other major cardiovascular disease events.
“This is an important milestone in a country which has the highest incidence of heart attacks. This study also demonstrates the organisation’s efforts to move beyond describing the state of cardiac care to taking concrete steps to improve the treatment and outcomes of patients with Acute Coronary Syndrome or heart attacks,” said Dr P P Mohanan, director and HOD of Cardiology, Westfort Hospital, Thrissur and one of the two principal co-investigators.
“I continue to be impressed with the passion and commitment of cardiologists in Kerala who work tirelessly to help their patients not only as individual physicians but also as an organisation,” according to Dr Mark Huffman, principal co-investigator from Northwestern University Feinberg School of Medicine.
Life-saving care
As part of the efforts to improve heart attack care, new study ACS QUIK recruited 21,374 patients from 63 hospitals between 2014-2016
The hospitals were first assigned to deliver usual care, but were then randomly assigned to implement a quality improvement toolkit which included audit and feedback reporting, checklists, patient education materials and linkage to emergency cardiovascular care training
This simple toolkit improved the quality of care among hospitals which received it