About the Alberta Provincial Project for Outcome Assessment in Coronary Artery Disease

The right patients receiving the right treatments at the right times

<Click for a downloadable brochure about APPROACH.>

APPROACH's mission is to collect and process information to improve cardiac care for all Albertans.

The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) is an ongoing, prospective data collection initiative that began in 1995. APPROACH collects data for all patients undergoing cardiac catheterization in Alberta. Patients are followed long-term, with information also collected at the time of angioplasty, also known as percutaneous coronary intervention (PCI), and at time of coronary artery bypass graft (CABG) surgery.

Hospitals currently using the APPROACH database can access the patient’s historical record readily, allowing cardiologists and surgeons to make timely treatment decisions. The database can also generate reports for hospital administrators, health officials and planners, and be used by researchers examining questions of health care in Alberta.

In addition to collecting information at the points mentioned above, a questionnaire is sent to consenting patients one year after their angiogram, and then every second year thereafter. APPROACH researchers use this data to determine long-term clinical, economic, and health status outcomes.

APPROACH 2004 and beyond

In 2004, APPROACH expanded data collection to include acute coronary syndrome (ACS) admissions through an initiative called Heart Alert. The goal of this initiative is to improve cardiac care services by further enhancing communication between health care professionals across Alberta.

At participating hospitals, information will now also be collected into the APPROACH database when patients are admitted with a cardiac emergency (rather than only when a patient undergoes an angiogram). This will expand the number of hospitals who have access to APPROACH from only those hospitals that perform angioplasty (in Calgary and Edmonton) to potentially all 103 acute care hospitals in the province of Alberta, assisting health care providers with treatment decisions regardless of location.

The second part of Heart Alert is to assist in developing the capability for emergency medical service (EMS) paramedics to transmit ECGs electronically to a central ECG database. Cardiologists, emergency department doctors, and nurses in any participating location can review the ECG immediately, often making treatment decisions and preparations before the patient has even arrived at the hospital. With this capability, the time required to transfer patients and prepare for emergency cardiac care can be significantly decreased, significantly improving patient outcomes.

APPROACH’s goal is to have ACS data collection implemented in all Alberta hospitals by 2007. In October 2004, Heart Alert facilitated ECG transmissions by EMS units within the city of Calgary. It is Heart Alert's goal to enable all EMS units in the province the ability to transmit ECG's to a centralized archiving system thus expediting treatment decision times. <Click here for more information about Heart Alert.>

Research and reports

The APPROACH registry provides opportunities to examine the fairness and effectiveness of Alberta’s provision of cardiac health care. Research done by the APPROACH team is recognized by many health care institutions and universities and has appeared in high-impact, international and national journals. <Click here for information on the most recently published research topics.>

The APPROACH team has developed regular reports that allow hospital administrators and health officials and planners in their decision making. <Click here for an example report>.

Patient-identifiable information is not provided to researchers who use APPROACH data. Therefore, individual patients cannot be identified in reports or research. <See Privacy Statement for more information.>