Electronic Toolkit Improves Care of Heart Patients

A quality improvement toolkit assists hospital medical, surgical, pharmacy, and nursing staff to conduct an audit of the discharge management of patients with acute coronary syndromes (ACS).

The discharge management of acute coronary syndromes (DMACS) drug use evaluation (DUE) audit tool is a standalone Microsoft Windows application that can be easily downloaded and used by hospital pharmacists, nurses, cardiology staff, quality managers, and graduates. The toolkit was created following an Australian national quality improvement project in 49 Australian public and private hospitals. The toolkit contains an electronic audit tool for data collection and summary reporting, resources to support the DUE process, and educational resources to assist healthcare professionals improve their knowledge and implement learning about the discharge management of patients with ACS.

The DMACS e-DUE enables data entry, automated analysis of data and generation of a summary report on selected key measures following data collection. Parameters entered into the audit tool, which is designed as an electronic form worksheet, include demographic data, diagnosis, co-morbidites, drug use, and discharge follow-up. An important part of the process is compulsory telephone follow-up of all patients and reevaluation of medications and compliance. The summary report helps identify aspects of the discharge management of ACS requiring improvement, including outcomes, processes, and systems of care. The DMACS e-DUE toolkit is available for free download from the Australian National Prescribing Service (NPS; Sydney, Australia).

"When patients feel supported they are more likely to stick with their treatment plans. This new tool will help ensure optimal care at and following discharge, and promote better communication between hospital staff, patients, carers, and community health providers," said associate professor of pharmacy Danielle Stowasser, MD, of the University of Queensland (Brisbane, Australia).

ACS include a broad spectrum of clinical presentations, which may include acute myocardial infarction (MI), ST-segment elevation MI, non-ST-segment elevation MI, enzyme/troponin-diagnosed MI, late electrocardiogram (ECG)-diagnosed MI, or unstable angina. Clinical presentation may include symptoms of chest discomfort at rest for a prolonged period, recurrent chest discomfort, or discomfort associated with syncope or acute heart failure. Other presentations of ACS may include back, neck, arm or epigastric pain, chest tightness, dyspnea, diaphoresis, and nausea and vomiting.

Related Links:
Australian National Prescribing Service
University of Queensland