Conclusions Organisational and professional interventions improved prescribing of statins/lipid-lowering agents and target blood pressure in patients with IHDs but there was little evidence of change in other outcomes .
Objectives Ischaemic heart diseases ( IHDs ) are a leading cause of death worldwide .
Although prescribing according to guidelines improves health outcomes , it remains suboptimal .
We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs .
Targeted versus standard feedback: results from a randomized quality improvement trial.
BACKGROUND Quality improvement is central to improving the care of patients with cardiovascular disease ; however , the optimum type of data feedback to support such efforts is unknown . METHODS Over 26 months , 149 eligible Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines hospitals were r and omized to receive either st and ard ( n = 76 control ) or targeted ( n = 73 intervention ) performance feedback reports for acute myocardial infa rct ion patient care . Each report summarized performance on identified metrics ( providing hospitals with detailed data on their 3 lowest-performing quality metrics , relative to their peers ) . Intervention sites received 5 targeted feedback reports .  Overall composite performance was compared between cohorts at end of study and as a change from baseline . RESULTS Intervention ( n = 60 ) and control ( n = 64 ) hospitals that completed the study had similar baseline performance ( median score 83.7 % vs 84.2 % ) . Over 26 months of follow-up , the change in overall composite score across hospitals was neutral ( median 0.1 % [ interquartile range { IQR } -2.4 % to 3.3 % ] ) . There was no difference in observed improvement in either the intervention ( median -0.2 % [ IQR-2.6 % to 3.3 % ] ) or control ( median 0.1 % [ IQR -2.2 % to 3.4 % ] ) hospitals . CONCLUSIONS We were unable to demonstrate that targeted performance feedback reports lead to more rapid care improvements than st and ard reports . Future directions should explore the relationship between hospital self- selection of targeted metrics and the identification and promulgation of less common metrics -- particularly those that reflect processes of care
Conclusions Organisational and professional interventions improved prescribing of statins/lipid-lowering agents and target blood pressure in patients with IHDs but there was little evidence of change in other outcomes .
Objectives Ischaemic heart diseases ( IHDs ) are a leading cause of death worldwide .
Although prescribing according to guidelines improves health outcomes , it remains suboptimal .
We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs .