Optimizing care and quality indicators in the management of patients with acute ischaemic heart disease and atherothrombotic stroke: measuring to improve

Abstract

Background: Acute ischaemic heart disease (AIHD) and atherothrombotic stroke are amongst the leading causes of mortality and disability worldwide, sharing pathogenic mechanisms. Quality indicators (QIs) are essential tools for evaluating and optimizing clinical management. The aim of this article is to develop an integrated organizational model for the care of AIHD and atherothrombotic stroke, incorporating validated and measurable QIs to improve patient outcomes and care coordination.

Methods: A multidisciplinary panel of cardiologists, neurologists, internists, primary care physicians and nursing staff reached a consensus through structured meetings. After reviewing the literature and scientific recommendations, the most relevant QIs were selected. When clear standards were lacking, the panel established criteria by consensus. The selected QIs were integrated into a care pathway covering the pre-hospital phase through longterm follow-up.

Results: Sixteen key QIs were identified for each process, covering intervention times, secondary prevention, patient satisfaction, rehabilitation, follow-up and clinical outcomes. The model highlights the importance of rapid diagnosis, timely interventions and coordinated discharge planning. Early initiation of intensive lipidlowering therapy and systematic monitoring of targets such as LDL-c and mortality are emphasized.

Conclusion: The proposed QIs and organizational model can be valuable tools for optimizing care and coordination for patients with AIHD and atherothrombotic stroke. They enable the monitoring and improvement of critical aspects of the care process.

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