The National Audit of Myocardial Infarction: a new development in the audit process

The Myocardial Infarction National Audit Project (MINAP) is a response by the profession to the audit requirements of the National Service Framework (NSF) for Coronary Heart Disease. The project is based on a dataset, now incorporated in the National Health Service (NHS) data dictionary, which allows examination of the process of care and outcome of all acute coronary syndromes. The project uses secure online connections from hospitals to central servers developed by the Central Cardiac Audit Database (CCAD) in order to provide contemporary analyses of hospital performance against NSF targets and other analyses of value to clinicians. The security and confidentiality of identifiable data have received critical attention, and the system is considered secure and robust. In addition to online views provided to hospitals, detailed quarterly performance reports are created automatically for hospitals, strategic health authorities and the Department of Health. An annual report is created for the general public. This project now covers 224 English and Welsh hospitals, and the database contains more than 125 000 records. This project has become a powerful tool with which to examine the care and outcome for patients with acute myocardial infarction and other acute coronary syndromes.