IJCS | Volume 32, Nº6, November / December 2019

DOI: 10.5935/2359-4802.20190034 607 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(6):607-614 Mailing Address: Prof. Dr. Gilson Soares Feitosa-Filho Coordenação de Ensino – Hospital Santa Izabel - Praça Conselheiro Almeida Couto, 500. Postal Code: 40050-410, Nazaré, Salvador, BA - Brazil. E-mail: gilsonfeitosafilho@yahoo.com.br Effect of Hospital Accreditation Process in Outcomes of Patients with Acute Coronary Syndrome Carolina de Deus Leite, 1 T hiago Carvalho Pereira, 2 M atheus Pamponet Freitas, 2 N atália Lima Walsh Tinôco, 1 Flávia Guimarães Pereira, 1 R oberta Vicente Leite Viana Menezes, 1 M ilena Quadros Sampaio Andrade , 1 S amantha Pereira Rosa Vilas Boas, 1 P aulo José Bastos Barbosa, 1 ,2 G ilson Soares Feitosa-Filho 1, 2 Escola Bahiana de Medicina e Saúde Pública, 1 Bahia, BA – Brazil Hospital Santa Izabel da Santa Casa de Misericórdia da Bahia, 2 Bahia, BA – Brazil Manuscript received April 03, 2018; revised manuscript August 20, 2018; accepted October 09, 2018. Abstract Background: Hospital accreditation has as goal the standardization of patient care, aiming quality improvement. On 2015, a cardiology reference hospital was evaluated and got level 3 from ONA in care given to Acute Coronary Syndrome (ACS) patients. Objetive: To compare length of stay (LOS) at Coronary Care Unit (CCU) and the total LOS at the hospital of ACS patients before and after ONA 3 accreditation. Other clinical outcomes were also analyzed. Methods: Systematic and prospective registry of admitted ACS patients at CCU, whose populationwas divided into pre-accreditation (period 1) and post-accreditation (period 2). Descriptive analysis was performed. For statistical analysis the Mann-Whitney test, chi-squared, Fisher’s exact test and Multiple Linear Regression were performed. P value was considered statistically significant when < 0,05. Results: 372 patients were admitted with ACS, 186 in period 1, of which 47 (25,3%) with ST segment Elevation Myocardial Infarction (STEMI), and 186 in period 2, of which 70 (37,6%) with STEMI. The mean age was 65,9 years (± 12,2). About the CCU LOS, there was a reduction from 3 (IQR: 2-4) to 2,5 days (IQR: 2-4; p value = 0,088). Regarding the hospital LOS, there was also a reduction from 8 (IQR: 5-12,25) to 6 days (IQR:4-11; p value = 0,004). Analyzing the type of ACS, there was a significant reduction only at the hospital LOS in non-STEMI patients: 8 to 6 days (p value = 0,001). Other hospitalization length of stay and clinical outcomes did not present a significant reduction in the comparison. Conclusion: After the ONA 3 accreditation, there was a reduction of hospital LOS. There were no significant differences in the other outcomes analyzed. (Int J Cardiovasc Sci. 2019;32(6):607-614) Keywords: Hospital Accreditation; Consensus; Acute Coronary Syndrome; Data Interpretation, Statistical; Coronary Care Units. Introduction Institutions that offer health services face challenges in improving safety and quality 1-4 , and it is therefore critical that a global organization be in place for all sectors towork in a systematic way 1,5 . Constant evaluation of this system proves to be useful to ensure its smooth operation 3,6 . Hospital quality certification has then emerged. It is a process of continuing professional education that helps to encourage perfecting through multidisciplinary procedures that improve patient hospitalization and ensure lower rates of in-hospital complications. 3,6-8 Hospital accreditation programs, which are forms of certification in many parts of the world have proven to be a method that assists in the evolution of the quality of health services, besides serving as an external validation of the service 1-3,9,10 . These programs analyzemany criteria, ranging from hospital infrastructure to teaching and