Myocardial Infarction (MI) Full Care Cycle and Patient Outcomes

In France, about 100,000 patients each year have an MI. Of those entering the care pathway, 5% die within the 1st month, 13% die during the first year and only a quarter is benefiting from the optimal emergency care pathway:
1st signs of ACS – call the SAMU center 15 – emergency medical care management with direct referral to interventional cardiology center.

Our objectives

• To reduce the overall mortality and complications of MI
• To improve the 3 phases of MI care pathways, before, during & after hospitalisation
• To improve patient experience and outcomes
  

Our method

• A Collaborative Method: A National MI Task Force multiprofessional & multidisciplinary to capitalise on clinical expertise, scientific evidence and practice results
• Shared Clinical Indicators adressing the ESA Quality dimensions: Efficacy/Efficiency, Safety & Access
• A patient centred approach considering the 3 consecutive phases of MI care pathways to improve Practices & Patient Outcomes

Our results

Clinical Practice Indicators to measure MI Management & Patient Outcomes from pain onset up to 1 year of follow up

• List of the Clinical Practice Indicators
• Clinical Practice Indicators: the complete document

Improving outcomes: Actions & Figures from the field

• HAS Myocardial Infarction Plenary: before, during & after hospitalisation, Paris, 17^th June 2012
• HAS International Expert Seminar "Full care cycles'', Paris, 15^th-16^th December 2011
• HAS Cardioneurovascular Plenary, Paris, 2^nd Februrary 2011
• ISQUA: Improving patient outcomes through integrated care pathways for stroke & myocardial infarction: international experiences - access to brochure, Paris, 13^th October 2010
• HAS - BMJ Symposium: Clinical impact of quality improvement, Paris, 19^th April 2010
  Session posters
  > Cardio Neuro Vascular Prevention Lane: abstracts, posters & videos
  > Acute Myocardial Infarction Street: abstracts, posters & videos
  > Grand Square: abstracts, posters & videos
        - N° 281: Integrating Efficacy, Safety & Access into quality of Care: abstract / poster / video
        - N° 275: Trends in the quality of myocardial infarction management in France: from evidence-based
          medicine to optimal clinical pathways. To access abstract / poster / video

Conclusions from practices & priorities for action

• For 2012: in progress
• For 2009: Progress Reports on the 3 phases of MI care pathway: phase 1, phase 2, phase 3

Our prespectives

Measuring Patient experience allows to identify room for improvement in MI care management, before, during and after hospitalisation. Involving Patients in measuring their Experience of care, is a powerfull lever for care quality & Outcomes Improvement.

References

• Myocardial Infarction & Secondary Prevention references

April 2013