Brazilian Intervention to Increase Evidence Usage in Practice - Acute Coronary Syndromes

STUDY POPULATION:

Patients with thoracic pain who the emergency department physician suspects of ACS and plans start a treatment for this issue; It will be excluded patients transferred of others institutions with 12 hours of symptoms.

PROGRAM:

There are multifaceted Interventions Including

• Distribution of educational materials
• Case manager: Use of a trained person who works in the hospital and will be responsible to assure that all interventions were used
• Reminders: specific information that is designed or intended to prompt a health professional to recall information (patient bracelets, labels, posters, pocket cards, checklists).
• Practical training

ENDPOINTS:

Phase 1 Primary outcome; patient who've received interventions based on evidence proportion informed by the indicators; Phase 2

Primary outcome:

Increase of prescription of evidence based treatment in clinical practice Secondary outcome Total mortality and major cardiovascular events

Patient Eligibility criteria

Inclusion criteria

• Patients with thoracic pain who the emergency department physician suspects of ACS and plans start a treatment for this issue

Exclusion criteria

• Patients transferred from others institutions within 12 hours of the symptoms

Cluster Eligibility Criteria

• National Public Hospitals with emergency department. A cluster can be one hospital with emergency department, or 2 or more hospitals (for example: 1 emergency hospital and 1 general hospital which receive the patients to perform PCI).