Table 7

Results of EPA Cardio and Vitale Vaten considering the list of 27 organisational indicators presented in both procedures

	EPA set	Vitale Vaten set
Infrastructure
1. The practice should have a system for offering all patients with chronic illness (eg, established CVD: CHD, stroke, TIA or PVD—see glossary), a check-up/review at least once in the last 15 months		V
2. Patients who smoke and are recorded as being motivated to stop should be offered at least one follow-up consultation within 3 months	V	V
3. For all patients who are obese (body mass index >30 kg/m²) there should be a record that they have been offered at least one follow-up consultation within the last 15 months		V
4. All practices should use an electronic disease classification system that can be used to create registers of patients with established CVD (CHD, stroke, TIA or PVD: see glossary) for example International classification of Primary Care, READ Codes		V
5. All practices should use an electronic disease classification system that can be used to create registers of patients at risk of CVD (hypertensives, etc)—for example, International classification of Primary Care, READ Codes		V
6. All patients at high risk (eg, chronic respiratory disease, established CVD (CHD, stroke, TIA or PVD—see glossary), chronic heart disease, chronic renal failure, diabetes, immunosuprression of any cause, residents of nursing homes, etc, anyone aged >65) should be offered flu vaccination in the preceding flu season (eg, 1 September to 31 March or 1 September to 31 December)	V
People
1. All GPs should attend at least one training/continuing medical education event on CVD within the last 5 years
2. At least one general practitioner per practice should attend at least one training/continuing medical education event on CVD within the last 15 months
3. All nurses should attend at least one training/continuing medical education event on CVD within the last 5 years
4. At least one nurse per practice should attend AT LEAST one training/continuing medical education event on CVD within the last 15 months		V
5. General practitioners should take part in education about CVD risk factors (eg, diet, exercise, smoking) in schools
6. Nurses should take part in education about CVD risk factors (eg, diet, exercise, smoking) in schools
7. General practitioners should take part in local/community campaigns or actions on CVD risk prevention (eg, stop smoking campaigns, fun runs, etc)
8. Nurses should take part in local/community campaigns or actions on CVD risk prevention (eg, stop smoking campaigns, fun runs, etc)
Information
1. The medical record should contain a summary list of major medical problems	V	V
2. The medical record should contain details of current actual prescribed medication	V	V
3. The medical record should contain information about intolerances and contraindications to medication	V	V
4. Information leaflets about CVD (eg, CHD, stroke, hypertension, stopping smoking, etc) should be available at the practice for patients to take home or read in the practice		V
5. Advice to patients about CVD risk factors/lifestyle should be based on using validated assessment tools (eg, food frequency questionnaire, International Physical Activity Questionnaire, etc)
6. A CVD risk assessment tool should be integrated with the patient medical record system (eg, so that the CVD event risk score is entered directly in to the patient's medical record)		V
7. CVD risk advice (eg, about modifiable risk factors such as diet and exercise) should be integrated with the patient medical record system		V
8. Smoking status should be clearly identifiable on the paper and/or electronic record	V	V
9. The diagnosis of hypertension should be clearly identifiable on the paper and/or electronic record	V	V
10. The diagnosis of diabetes should be clearly identifiable on the paper and/or electronic record	V	V
11. The diagnosis of CVD should be clearly identifiable on the paper and/or electronic record	V	V
12. The practice has an up-to-date directory of prevention activities/organisations available locally (eg, gyms, walking group, weight-watchers, etc)		V
Quality and safety
1. The practice should have a team meeting about quality improvement relating to CVD at least once in the last 15 months

CHD, coronary heart disease; CVD, cardiovascular disease; PVD, peripheral vascular disease; TIA, transient ischaemic attack; v, rated valid.