ABC | Volume 115, Nº1, July 2020

97 Original Article Taniguchi et al. Best practice in cardiology (BPC) program Arq Bras Cardiol. 2020; 115(1):92-99 motivation, and still in others to increase or to restrain the supply of opportunities, individually or jointly, depending on the objectives of each institution. Interventions such as the award program that was considered one of the keys for success in the GWTG experience will be emphasized in all participating institutions. 40 Lessons learned from the IHI open school experience, such as shaping the audit and feedback intervention with run charts, will be also used in this project. 41 These approaches consider institutional longitudinal data on the several quality metrics not only in relation to the average benchmarks of the other participating institutions, but also to the goal established for that institution by the median line of the scores obtained for the entire period of observation. 27,41 This feedback loop allows the institution to continuously evaluate itself and redesign processes in rapid improvement cycles, 25,26 considering how their performance differs from the objective and whether adjustments made in their multidisciplinary interventions are resulting in sustained improvement. Conclusion This novel QI program will be provided to selected public institutions in Brazil addressing issues pertaining to the local context that will allow for the identification of specific barriers to the adoption of standards of care. It has the potential to provide solutions that can result in sustained improvement in adherence to evidence-based therapies and patient outcomes. It is hoped that the implemented strategies will contribute to creating an organizational culture focused on the construction and exchange of knowledge among the institutions nationwide, thereby advancing the quality of cardiovascular health care in Brazil. Financial support This study is supported by TAKEDA and Pfizer Independent Grants for Learning and Change, in partnership with the SBC, and by a grant of the Brazilian Ministry of Health through PROADI-SUS. 42 ALPR receives scholarships from Brazilian research agencies CNPq and FAPEMIG. Acknowledgements To Dr. Leopoldo Soares Piegas and to Dr. Felix José Alvares Ramires for the contributions made to the initial design of this Project and for sharing their experience on implementing QI strategies on HF and ACS in the HCor. Author contributions Conception and design of the research: Taniguchi FP, Bernardez-Pereira S, Silva SA, Morgan L, Taubert K, Smith Jr. SC, Paola AAV, Curtis AB; Acquisition of data: Toth CPP, Morosov EDM, Analysis and interpretation of the data: Taniguchi FP, Bernardez-Pereira S, Silva SA, Chrispim PPM, Toth CPP, Morosov EDM; Statistical analysis: Bernardez-Pereira S, Silva AS; Obtaining financing: Taniguchi FP, Morgan L, Taubert K, Weber B, Smith Jr. SC, Paola AAV, Curtis AB; Writing of the manuscript: Taniguchi FP, Bernardez-Pereira S, Silva SA, Ribeiro AL; Critical revision of the manuscript for intellectual content: Taniguchi FP, Bernardez-Pereira S, Silva SA, Ribeiro AL, Morgan L, Taubert K, Weber B, ChrispimPPM, Toth CPP, Morosov EDM, FonarowGC, Smith Jr. SC, Paola AAV, Curtis AB. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by PROADI-SUS and partially funded by American Heart Association Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate ThisstudywasapprovedbytheEthicsCommitteeoftheHospital doCoração under the protocol number 48561715.5.1001.0060. All the procedures in this study were in accordancewith the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Victora CG, BarretoML, do Carmo Leal M, Monteiro CA, Schmidt MI, Paim J, et al. Health conditions and health-policy innovations in Brazil: the way forward. Lancet. 2011;377(9782):2042-53. 2. Gragnolati M, LindelowM, Couttolenc B. Improving efficiency and quality of health care services. In. Twenty years of health system reform in Brazil: an assessment of the Sistema Único de Saúde. Washington, DC: TheWorld Bank; 2013. 3. 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