Background: Assessing the quality of care is the first step for improve the management of patients with acute myocardial infarction (AMI). The European Society of Cardiology (ESC) and the Acute Cardiovascular Care Association (ACCA) recently defined a set of quality indicators (QI) of care for AMI.
Aim: To evaluate the quality of care of patients admitted to the Cardiology ward of our first level hospital for an AMI using the ESC ACCA QI.
Methods: QiC project is a prospective quality improvement study in real-world practice on all patients admitted to our ward for an AMI from 1.5.2023 to 30.4.25 with six-monthly audit activities. Case record forms were filled in by doctors during admission and were attached to the patient’s discharge letter. Thirty-day mortality was assessed by telephone interviews. The ESC ACCA QI include 18 main and 8 secondary QI on centre organization, reperfusion and invasive strategy, risk assessment, antithrombotic treatment, secondary prevention discharge treatments, and patient experience. For each IQ was evaluated the percentage of QI assessable and attained.
Results: A total of 78 patients were admitted for AMI in our Cardiology Department in the first 3 months. No one patient denied consent, one died during hospitalization, 7 patients had to be transferred to another hospital, and 3 patients did not have their record form filled in. The median age of the 67 patients discharged alive was 66 (IQR 58-75) years, 45 (67.2%) were males, 35 (52.2%) had a ST-segment elevation myocardial infarction (STEMI) and 32 (47.8%) a non-ST-segment myocardial infarction (NSTEMI). The percentages of non-assessment, non-attainment and attainment for each QI are reported in the Figure: the degree of non-assessment of the 26 QI ranged from 0 to 22% and the degree of QI attainment from 25 to 100%.
Conclusions: Quality of care for acute myocardial infarction can be measured in the majority of patients admitted to our Cardiology Department using the ESC ACCA quality indicators. Although most quality indicators are met in our patients, a large room for improvement is present in the reperfusion and invasive strategy (mainly in timely reperfusion of STEMI patients) and in the patient’s satisfaction (discharge letter sent to patient).
