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Engaging clinicians in QI via national audit

Myocardial Ischaemia National Audit Project (MINAP)

The Myocardial Ischaemia National Audit Project (MINAP) was established in 1999, in response to the national service framework (NSF) for coronary heart disease, to examine the quality of management of heart attacks (myocardial infarction) in hospitals in England and Wales.

The project uses a highly secure electronic system of data entry, transmission and analysis developed by the Central Cardiac Audit Database (CCAD). This system uses encryption of patient identifiers to allow secure transfer of data between hospitals and central servers and allows linkage with the Office of National Statistics for tracking of mortality.

Initially the project focused on the hospital management of ST elevation myocardial infarction. However the dataset has been expanded to cover other acute coronary syndromes (ACS) and the introduction of pre-hospital thrombolysis and primary percutaneous intervention. All hospitals in England and Wales that admit patients with acute coronary syndromes contribute data. In September 2006, the database contained more than 467,000 records.

Aims of the audit

  • The audit enables hospitals to measure their performance against targets in the national service framework to monitor and improve the care of heart attack patients.
  • In addition, it now allows hospitals to monitor the care of all ACS patients.

In 2003, the Society of Cardiothoracic Surgeons (SCTS) agreed to use the Central Cardiac Audit Database (CCAD) - a technical infrastructure which provides a secure data collection and analysis service for the collection of datasets. This system is still used to date to collect and provide secure access to data, analysis and provides long term mortality tracking for all cardiac surgical patients to NHS and private healthcare organisations

In addition the service provides data extracts and analytical support for the Care Quality Commission's (formerly the Healthcare Commission) heart surgery website.

Organisation of the audit

The audit is managed by the National Institute for Clinical Outcomes Research at University College London in conjunction with the British Cardiac Society. Data is held and analysed on servers managed by CCAD, which is part of the Health and Social Care Information Centre.

Click here to visit the audit website >

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