• Su-San Liem, Barend L van der Hoeven, Pranobe V Oemrawsingh, Jeroen J Bax, Johanna G van der Bom, Jan Bosch, Eric P Viergever, Cees van Rees, Iman Padmos, Meredith I Sedney, Henk J van Exel, Harriette F Verwey, Douwe E Atsma, Enno T van der Velde, J Wouter Jukema, Ernst E van der Wall, and Martin J Schalij.
• Leiden University Medical Center, Leiden, The Netherlands.
• Am. Heart J. 2007 Jan 1; 153 (1): 14.e1-11.

BackgroundGuideline implementation programs for patients with acute myocardial infarction (AMI) enhance adherence to evidence-based medicine (EBM) and improve clinical outcome. Although undertreatment of patients with AMI is well recognized in both acute and chronic phases of care, most implementation programs focus on acute and secondary prevention strategies during the index hospitalization phase only.HypothesisImplementation of an all-phase integrated AMI care program maximizes EBM in daily practice and improves the care for patients with AMI.AimThe objective of this study is to assess the effects of the MISSION! program on adherence to EBM for patients with AMI by the use of performance indicators.DesignThe MISSION! protocol is based on the most recent American College of Cardiology/American Heart Association and European Society of Cardiology guidelines for patients with AMI. It contains a prehospital, inhospital, and outpatient clinical framework for decision making and treatment, up to 1 year after the index event. MISSION! concentrates on rapid AMI diagnosis and early reperfusion, followed by active lifestyle improvement and structured medical therapy. Because MISSION! covers both acute and chronic AMI phase, this design implies an intensive multidisciplinary collaboration among all regional health care providers.ConclusionContinuum of care for patients with AMI is warranted to take full advantage of EBM in day-to-day practice. This manuscript describes the rationale, design, and preliminary results of MISSION!, an all-phase integrated AMI care program.

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