Networks for improving care in patients with acute coronary syndrome: A framework

Abstract

In recent years, it has become evident that the level of guideline adherence in patients presenting with acute coronary syndrome (ACS) is highly correlated with patient outcomes. Unfortunately, guideline adherence is low in some geographic areas and especially in those patients at high-risk. Regional networks including ambulance systems and hospitals with catheterization laboratories are able to increase guideline adherence and patient outcomes by streamlining the critical pre- and intra-hospital processes as well as improving timely access to invasive procedures and recommended medication. Successful organization of an ACS network requires engagement of multiple stakeholders to create effective solutions for the specific local setting. There is no ‘one-size-fits all’ strategy to set-up and successfully run an ACS network. We present a framework for how to set up and organize an effective ACS network, delivering guideline-based care to improve patient outcomes.

Keywords::

• Acute coronary syndromes
• guideline adherence
• organization
• systems of care

Acknowledgements

Working meetings of the authors have been supported by an unrestricted grant from AstraZeneca. The company has had no involvement in the preparation of this manuscript which reflects the independent views of the authors.

Declaration of interest: D. Ardissino has received Research Grants, honoraria as speaker and was consultant for AstraZeneca.

J. P. Bassand reports receiving honoraria for Speakers’ Bureaus from AstraZeneca.

J. P. J. Halcox has consulted for and was a speaker on (CME accredited) meetings sponsored by AstraZeneca.

S. Halvorsen has received honoraria as speaker or consultant from AstraZeneca.

J. W. Jukema has received research grants from and was speaker on (CME accredited) meetings sponsored by AstraZeneca.

P. Kolh, within the last 12 months, received honoraria for consulting activities and to take part in scientific symposia from AstraZeneca.

S. D. Kristensen has received lecture fees from AstraZeneca.

J. Morais within the last 12 months received honoraria for consulting activities and to take part in scientific symposia from AstraZeneca.

M. J. Postma received grants and honoraria from AstraZeneca.

P. W. Radke has received honoraria as speaker and consultant from AstraZeneca.

J. P. Collet reports no conflict of interest.