Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 5;11(11):1651.
doi: 10.3390/healthcare11111651.

EASY-NET Program: Methods and Preliminary Results of an Audit and Feedback Intervention in the Emergency Care for Acute Myocardial Infarction in the Lazio Region, Italy

Laura Angelici  1 , Carmen Angioletti  2 , Luigi Pinnarelli  1 , Paola Colais  1 , Egidio de Mattia  3   4 , Nera Agabiti  1 , Marina Davoli  1 , Anna Acampora  1
Affiliations

EASY-NET Program: Methods and Preliminary Results of an Audit and Feedback Intervention in the Emergency Care for Acute Myocardial Infarction in the Lazio Region, Italy

Laura Angelici et al. Healthcare (Basel). .

Abstract

Within the EASY-NET network program (NET-2016-02364191), Work Package 1 Lazio evaluates the effectiveness of a structured audit and feedback (A&F) intervention compared with the web-based regional periodic publication of indicators in improving the appropriateness and timeliness of emergency healthcare for acute myocardial infarction (AMI). This work describes the A&F methodology and presents the results of the first feedback delivered. The intervention involves sending periodic reports via e-mail to participating hospitals. The feedback reports include a set of volume and quality (process and outcome) indicators, calculated by facility through the health information system of the Lazio Region and compared with regional mean, target values and values calculated for hospitals with similar volumes of activity. Health managers and clinicians of each participating hospital represent the "feedback recipients". They are invited to organize clinical and organizational audit meetings to identify possible critical issues in the care pathway and define, where necessary, improvement actions. A total of 16 facilities are involved. Twelve facilities present high volumes in all volume indicators, while three facilities present low volumes for each indicator. Concerning the quality indicators, four facilities do not present critical indicators or had average results, three facilities do not present critical indicators but show average results in at least one of the indicators and six facilities present a critical value for at least one of the indicators. The first report highlighted some critical issues in some facilities on several indicators. During the audit meetings, each facility analyzes these issues, defining appropriate improvement actions. The outcome of these actions will be monitored through subsequent reporting to support the continuous care quality improvement process.

Keywords: acute myocardial infarction; audit and feedback; emergency.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Number of hospitalizations of patients with AMI by facility (2021).
Figure 2
Figure 2
Number of hospitalizations of patients with STEMI treated with PTCA by facility (2021).
Figure 3
Figure 3
Proportion of patients with STEMI treated with PTCA within 90 min from access to ER, by facility (2021).
Figure 4
Figure 4
Mortality within 30 days after first admission to hospital for STEMI, by facility (2021).
Figure 5
Figure 5
Summary grid for (A) volume indicators (2021) and (B) process and outcome indicators (ADJ % 2021).
See this image and copyright information in PMC

References

    1. Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS) Programma Nazionale Esiti. [(accessed on 10 May 2022)];2021 Available online: https://pne.agenas.it/
    1. Flottorp S.A., Jamtvedt G., Gibis B., Mckee M. Using audit and feedback to health professionals to improve the quality and safety of health care; Proceedings of the Belgian EU Presidency Conference on Investing in Europe’s Health Workforce of Tomorrow: Scope for Innovation and Collaboration; La Hulpe, Belgium. 9–10 September 2010; [(accessed on 15 September 2022)]. Available online: https://apps.who.int/iris/handle/10665/332014?show=full.
    1. Davis D.A., Mazmanian P.E., Fordis M., Van Harrison R., Thorpe K.E., Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: A systematic review. JAMA. 2006;296:1094–1102. doi: 10.1001/jama.296.9.1094. - DOI - PubMed
    1. Hysong S.J., Kell H.J., Petersen L.A., Campbell B.A., Trautner B.V. Theory-based and evidence-based design of audit and feedback programmes: Examples from two clinical interventions studies. BMJ Qual. Saf. 2017;26:323–334. doi: 10.1136/bmjqs-2015-004796. - DOI - PubMed
    1. Ivers N., Jamtvedt G., Flottorp S., Young J.M., Odgaard-Jensen J., French S.D., O’Brien M.A., Johansen M., Grimshaw J., Oxman A.D. Audit and feedback: Effects on professional practice and healthcare outcomes. Cochrane Database Syst. Rev. 2012;6:1465–1858. doi: 10.1002/14651858.CD000259.pub3. - DOI - PMC - PubMed

LinkOut - more resources