临床指南的重要性.ppt

ImplementingtheGuidelines:CriticalPathways酮纵磷床机睹列浴段眉户日触挚箩裴滨值诉梆羽构乌茸频咯顾斑萌颇伸拓临床指南的重要性临床指南的重要性AwarenessIsNotEnough!NCEP,,;160:459-%38%020406080100PhysicianAwarenessofNCEPGuidelinePatientTreatedtoGoalSample(%)吞糕佯窒氏拾叼翱血穷寻坝航穿聋湘鞋谨羌烹衅揉黄钻营饺券侵锣裂万测临床指南的重要性临床指南的重要性GUIDELINESCardiologyAcuteCarePrimaryCareSecondaryPreventionSmoothTransitionFromAcutetoLong-termManagement跳健莫陀齐笆瓶柜技妨陕颠砰脉尧产谨致昌茧倦翼懂艾林杆抒裁厢洛娠收临床指南的重要性临床指南的重要性WhyDevelopCriticalPathways?“Atreatmentgapbetweentherapythatisdictatedbyevidence-ursinpracticeisnotadeficitofknowledge;rather,itisadeficitofimplementation.” SidneySmith,MD ChiefScientificOfficer, AmericanHeartAssociation庭窜爵芯制钻镁呐卫媒腺卉沿泼呢兑到勃迸斡熙煤谭游定准矫萎瓮详绞心临床指南的重要性临床指南的重要性StandardizedprotocolsGoal:optimizecareEmergingEvidence—Pathwayswork:CHAMPGuidelinesAppliedinPractice(GAP)AHAGetwiththeGuidelinesprogramP,:CHAMPStudyDesignedtodeterminewhetherphysician/pliancewithpreventivetherapiescanbeimprovedthroughahospital-initiatedprogramTrackedinitiationofASA,-blocker,ACEinhibitor,andstatinsUsedpreprintedorders,guidelines,lectures,dischargeformsPopulation:Patientswithsymptomaticatherosclerosistreatedatuniversity-associatedteachinghospitalASA,acetylsalicyclicacid;ACE,angiotensin-,;85;10A-AtherosclerosisManagementProgram痛小宗玻疑恕甸遭幼叭扎充桔肿蝉它循售保西搐漓髓貉兵列温岁旦拭宋助临床指南的重要性临床指南的重要性CHAMPStudy:TreatmentRatesatDischargeand1-YearFollow-upCHAMP,CardiacHospitalizationAtheroscleroticManagementProgram.* P<.01pre-vspost-CHAMPatdischargeandat1year. FonarowGC,;87:819--CHAMPDischargePost-CHAMPDischargePre-CHAMPFollow-upPost-CHAMPFollow-upAspirin-BlockerTreatmentRates(%)7892*6894*1261*1857*豌二醇黍些剪坪弊臼怒虏赶馏鸣酒观菜昌呛梨褐诉彪柜波胺诊弥绵欧箱那临床指南的重要性临床指南的重要性CHAMPStudy:ClinicalEventsfortheFirstYearAfterDischargeforAcuteMICHAMP,CardiacHospitaliz