Imperial College London
Portrait Picture

Professor Kalipso Chalkidou

Faculty of Medicine, School of Public Health

Visiting Professor
 
 
 
//

Contact

 

k.chalkidou

 
 
//

Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Wu:2019:10.1001/jamacardio.2019.0897,
author = {Wu, Y and Li, S and Patel, A and Li, X and Du, X and Wu, T and Zhao, Y and Feng, L and Billot, L and Peterson, ED and Woodward, M and Kong, L and Huo, Y and Hu, D and Chalkidou, K and Gao, R and CPACS-3, Investigators},
doi = {10.1001/jamacardio.2019.0897},
journal = {JAMA Cardiol},
title = {Effect of a Quality of Care Improvement Initiative in Patients With Acute Coronary Syndrome in Resource-Constrained Hospitals in China: A Randomized Clinical Trial.},
url = {http://dx.doi.org/10.1001/jamacardio.2019.0897},
year = {2019}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Importance: Prior observational studies suggest that quality of care improvement (QCI) initiatives can improve the clinical outcomes of acute coronary syndrome (ACS). To our knowledge, this has never been demonstrated in a well-powered randomized clinical trial. Objective: To determine whether a clinical pathway-based, multifaceted QCI intervention could improve clinical outcomes among patients with ACS in resource-constrained hospitals in China. Design, Setting, Participants: This large, stepped-wedge cluster randomized clinical trial was conducted in nonpercutaneous coronary intervention hospitals across China and included all patients older than 18 years and with a final diagnosis of ACS who were recruited consecutively between October 2011 and December 2014. We excluded patients who died before or within 10 minutes of hospital arrival. We recruited 5768 and 0 eligible patients for the control and intervention groups, respectively, in step 1, 4326 and 1365 in step 2, 3278 and 3059 in step 3, 1419 and 4468 in step 4, and 0 and 5645 in step 5. Interventions: The intervention included establishing a QCI team, training clinical staff, implementing ACS clinical pathways, sequential site performance assessment and feedback, online technical support, and patient education. The usual care was the control that was compared. Main Outcomes and Measures: The primary outcome was the incidence of in-hospital major adverse cardiovascular events (MACE), comprising all-cause mortality, reinfarction/myocardial infarction, and nonfatal stroke. Secondary outcomes included 16 key performance indicators (KPIs) and the composite score developed from these KPIs. Results: Of 29346 patients (17639 men [61%]; mean [SD] age for control, 64.1 [11.6] years; mean [SD] age for intervention, 63.9 [11.7] years) who were recruited from 101 hospitals, 14809 (50.5%) were in the control period and 14537 (49.5%) were in the intervention period. There was no significant difference in the incidence
AU  - Wu,Y
AU  - Li,S
AU  - Patel,A
AU  - Li,X
AU  - Du,X
AU  - Wu,T
AU  - Zhao,Y
AU  - Feng,L
AU  - Billot,L
AU  - Peterson,ED
AU  - Woodward,M
AU  - Kong,L
AU  - Huo,Y
AU  - Hu,D
AU  - Chalkidou,K
AU  - Gao,R
AU  - CPACS-3,Investigators
DO  - 10.1001/jamacardio.2019.0897
PY  - 2019///
TI  - Effect of a Quality of Care Improvement Initiative in Patients With Acute Coronary Syndrome in Resource-Constrained Hospitals in China: A Randomized Clinical Trial.
T2  - JAMA Cardiol
UR  - http://dx.doi.org/10.1001/jamacardio.2019.0897
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30994898
ER  -
Download