ABSTRACT
Although numerous clinical trials have identified many advances in the treatment of
patients with acute coronary syndromes (ACS), registries of clinical practice have
identified that in clinical practice a large proportion of patients do not receive
guideline-recommended therapies. In addition to development and dissemination of national
guidelines, there is a need for specific tools to ensure that the guideline recommendations
are implemented on a patient-by-patient basis. Better adherence to practice guidelines
has been found to be associated with improved outcomes. Critical pathways and/or the
process of Continuous Quality Improvement (CQI) are means of trying to improve care.
Critical pathways are standardized protocols that aim to optimize and streamline patient
care, which usually involve standardized order sets, (or computerized ones), and/or
simple pocket cards, reminders, or checklists of the appropriate therapies. Another
key part of an overall CQI effort is to monitor data on performance-i.e. utilization
of guideline recommended therapies. Several well-conducted studies, showing that particular
use of critical pathways, can lead to improve quality of care.
KEYWORDS
Critical pathways - clinical pathways - unstable angina - myocardial infarction -
acute coronary syndromes
