An Organized Approach to Improvement in Guideline Adherence for Acute Myocardial Infarction

Open Access
Publisher Website
Google Scholar
Abstract
Despite a significant improvement in mortality over the last several decades, cardiovascular disease remains the leading cause of death in the United States, representing 36% of all deaths.1 While American Heart Association (AHA) and American College of Cardiology (ACC) guidelines summarize evidence-based recommendations,2,3 adherence to these guidelines in clinical medicine is both incomplete and highly variable.4,5 Guideline adherence has been shown to be dependent on geographic region, teaching status, and profit status.6 As a result of this observation, quality improvement programs, including the ACC Guidelines in Applied Practice (GAP) program7 and the AHA Get With The Guidelines–Coronary Artery Disease (GWTG-CAD) program,8 were developed. The GWTG-CAD program is the largest hospital-based, national performance initiative, and an analysis of the first 100 hospitals found improvements over the first year of participation compared with baseline.8