Evidência de melhora na qualidade do cuidado assistencial no infarto agudo do miocárdio

background: the monitoring of healthcare quality indicators (hcqi) is a process of utmost importance in patient healthcare services. objective: to evaluate whether the monitoring of hcqi and the root-cause analysis improve the healthcare quality in acute myocardial infarction (ami). methods: a cross-sectional and comparative analysis of hcqi was performed in patients with ami in the years 2006 and 2007. of the 1,461 patients admitted with chest pain, 172 (11.7%) had a diagnosis of ami and were included in the analysis. results: the rate of primary angioplasty was 8.47% higher in 2007 (97.3%) when compared to that in 2006 (89.7%), but this difference was not statistically significant (p = 0.35). moreover, there was no difference regarding the time of hospitalization (4 vs 5 days, p = 0.15) and the in-hospital mortality (7.8% vs 5.1%, p = 0.67) between 2007 and 2006, respectively. however, the time to the first troponin level was 27% shorter in 2007 (69 min.; 95%ci = 44-94 min.) when compared to 2006 (95 min.; 53-136 min.) (p = 0.025). the door-to-balloon time was 12% shorter (72 ± 29 min. vs 109 ± 85 min.; p = 0.03), the rate of asa prescription at hospital discharge was 35% higher (94.7% vs 70.3%; p = 0.002) and the rate of pca shorter than 90 minutes was 52% higher (78.3 vs 51.4%; p = 0.03) in 2007, when compared to 2006. conclusion: our results suggest that the strategy of monitoring the hcqi and the implementation of the root-cause analysis methodology can improve the healthcare process in patients with ami.