Rationale and design of the Improving Care for Cardiovascular Disease in China (CCC) project: A national effort to prompt quality enhancement for acute coronary syndrome

Am Heart J. 2016 Sep:179:107-15. doi: 10.1016/j.ahj.2016.06.005. Epub 2016 Jun 18.

Abstract

Background: A sizeable gap exists between guideline recommendations for treatment of acute coronary syndrome (ACS) and application of these recommendations in clinical practice. The CCC-ACS project is a novel national quality enhancement registry designed to help medical care providers bridge this gap, thereby improving clinical outcomes for ACS patients in China.

Methods and results: The CCC-ACS project uses data collection, analysis, feedback, rapid-cycle improvement, and performance recognition to extend the use of evidence-based guidelines throughout the health care system and improve cardiovascular health. The project was launched in 2014, with 150 centers recruited representing the diversity of care for ACS patients in tertiary hospitals across China. Clinical information for patients with ACS is collected via a Web-based data collecting platform, including patients' demographics, medical history, symptoms on arrival, in-hospital treatment and procedures, in-hospital outcomes, and discharge medications for secondary prevention. Improvement in adherence to guideline recommendations is facilitated through monthly benchmarked hospital quality reports, recognition of hospital quality achievement, and regular webinars. As of April 16, 2016, a total of 35,616 ACS cases have been enrolled.

Conclusions: The CCC-ACS is a national hospital-based quality improvement program, aiming to increase adherence to ACS guidelines in China and improve patient outcomes.

Trial registration: ClinicalTrials.gov NCT02306616.

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / therapy*
  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Angina, Unstable / blood
  • Angina, Unstable / diagnosis
  • Angina, Unstable / therapy*
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Benchmarking
  • China
  • Electrocardiography
  • Evidence-Based Medicine
  • Female
  • Guideline Adherence
  • Hospital Mortality
  • Hospitals
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists
  • Myocardial Revascularization
  • Non-ST Elevated Myocardial Infarction / blood
  • Non-ST Elevated Myocardial Infarction / diagnosis
  • Non-ST Elevated Myocardial Infarction / therapy*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Practice Guidelines as Topic
  • Professional Practice Gaps*
  • Quality Improvement*
  • Registries*
  • Retrospective Studies
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / therapy*
  • Secondary Prevention
  • Time-to-Treatment

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Mineralocorticoid Receptor Antagonists
  • Platelet Aggregation Inhibitors

Associated data

  • ClinicalTrials.gov/NCT02306616