Approach

APPROACH (Alberta Provincial Project for Outcome Assessment in Coronary Heart disease) is a practical, effective and patient-focused initiative with the stated mission to collect and process information to improve cardiac care. "The right patients receiving the right treatments at the right times." An important part of this initiative has been a da... ta-rich database that currently includes clinical information on 122,000 Albertans with diagnostic cardiac catheterization and/or revascularization procedures and, more recently, 32,000 patients with hospital admissions for acute coronary syndromes. This data continues to reveal important insights into short and long term quality indicators and management strategy effectiveness in Alberta and confirms to us that together we can do an even better job of caring for patients. The APPROACH team assisted in developing the capability for emergency medical service (EMS) paramedics to transmit ECGs electronically to a central ECG database. Cardiologists, emergency department doctors, and nurses in any participating location can review the ECG immediately, often making treatment decisions and preparations before the patient has even arrived at the hospital. With this capability, the time required to transfer patients and prepare for emergency cardiac care can be significantly decreased, significantly improving patient outcomes. Achieving the APPROACH mandate requires wide patient recruitment, promotion of clarity in clinical communication and extending observations over time to factor in both the acute events and the chronic realities of coronary artery disease. The Quality Indicators used in this work reflect a broad definition of treatment success that includes major clinical events as well as the results of a series of validated health status measurement tools. And, importantly, success in this area requires the ongoing skill and commitment of key outcome and information technology specialists and an acceptance of this work in a collaborative spirit within each partner ...Read More