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中国改善心血管疾病护理(CCC)项目的基本原理与设计:一项旨在促进急性冠状动脉综合征质量提升的全国性行动。

Rationale and design of the Improving Care for Cardiovascular Disease in China (CCC) project: A national effort to prompt quality enhancement for acute coronary syndrome.

作者信息

Hao Yongchen, Liu Jing, Liu Jun, Smith Sidney C, Huo Yong, Fonarow Gregg C, Ma Changsheng, Ge Junbo, Taubert Kathryn A, Morgan Louise, Guo Yang, Zhang Qian, Wang Wei, Zhao Dong

机构信息

Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.

Division of Cardiology, University of North Carolina, Chapel Hill, NC.

出版信息

Am Heart J. 2016 Sep;179:107-15. doi: 10.1016/j.ahj.2016.06.005. Epub 2016 Jun 18.

Abstract

BACKGROUND

A sizeable gap exists between guideline recommendations for treatment of acute coronary syndrome (ACS) and application of these recommendations in clinical practice. The CCC-ACS project is a novel national quality enhancement registry designed to help medical care providers bridge this gap, thereby improving clinical outcomes for ACS patients in China.

METHODS AND RESULTS

The CCC-ACS project uses data collection, analysis, feedback, rapid-cycle improvement, and performance recognition to extend the use of evidence-based guidelines throughout the health care system and improve cardiovascular health. The project was launched in 2014, with 150 centers recruited representing the diversity of care for ACS patients in tertiary hospitals across China. Clinical information for patients with ACS is collected via a Web-based data collecting platform, including patients' demographics, medical history, symptoms on arrival, in-hospital treatment and procedures, in-hospital outcomes, and discharge medications for secondary prevention. Improvement in adherence to guideline recommendations is facilitated through monthly benchmarked hospital quality reports, recognition of hospital quality achievement, and regular webinars. As of April 16, 2016, a total of 35,616 ACS cases have been enrolled.

CONCLUSIONS

The CCC-ACS is a national hospital-based quality improvement program, aiming to increase adherence to ACS guidelines in China and improve patient outcomes.

摘要

背景

急性冠状动脉综合征(ACS)治疗的指南建议与这些建议在临床实践中的应用之间存在相当大的差距。中国急性冠状动脉综合征注册研究(CCC-ACS)项目是一项新型的全国性质量提升注册研究,旨在帮助医疗服务提供者弥合这一差距,从而改善中国ACS患者的临床结局。

方法与结果

CCC-ACS项目利用数据收集、分析、反馈、快速循环改进和绩效认可,在整个医疗系统中推广循证指南的应用,并改善心血管健康。该项目于2014年启动,招募了150个中心,代表了中国各地三级医院对ACS患者的多样化治疗。ACS患者的临床信息通过基于网络的数据收集平台收集,包括患者的人口统计学信息、病史、入院时症状、住院治疗和操作、住院结局以及二级预防的出院用药。通过每月的医院质量基准报告、对医院质量成就的认可和定期的网络研讨会,促进了对指南建议的依从性改善。截至2016年4月16日,共纳入35616例ACS病例。

结论

CCC-ACS是一项基于全国医院的质量改进项目,旨在提高中国对ACS指南的依从性并改善患者结局。

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