Purpose – The purpose of this paper is to examine an operational process through the use of a clinical practice improvement method to implement clinical pathways in the Amber Hospital's (name changed for privacy reasons) cardiology unit. This quality framework has been adopted as a means of preventing adverse events, to ensure quality of care is provided to all patients. Design/methodology/approach – A quality assurance case study approach was adopted along with the clinical practice improvement method – a framework that allows continuous quality improvement to be applied in a practical way to clinical processes, in order to improve delivery of care. The clinical practice improvement method is broken into five cycles: project, diagnostic phase, intervention, impact, and sustaining improvement. The paper explains these cycles, demonstrating how each was achieved. Findings – The clinical practice improvement method at Amber Hospital was found to provide superior performance in the clinical pathway allocation process and improved patient care. Having an appropriate and effective action plan involving clinical pathways helps to prevent service hindrances that may have adverse impact on hospital management processes leading to adverse events. The Amber Hospital case study has not only identified the physical constraints but also the constraints in relation to organization policies and operation procedures. Research limitations/implications – The paper highlights the need for organizations to have a “no blame” culture, which acknowledged that errors do and will occur. However, it is also recognized that it is important to have reliable data collection on these errors, in order to reduce the frequency and severity of adverse events. Lack of available data was a severe limitation. Practical implications – The practical aim of this project was to improve recommended drug treatment in patients with Acute Coronary Syndrome through the implementation of clinical pathways. The author also wanted to measure the utilization rate of these pathways. While there were four pathways implemented, the majority of patients were allocated to pathway 1B. Hence, data were collected on those specific patients. Originality/value – Quality operational framework, using a clinical practice improvement method, demonstrated how clinical pathways for Acute Coronary Syndrome were implemented successfully at the Amber Hospital. The report provides evidence that through conducting a CPI project, quality improvements were made in recommended drug treatment for patients diagnosed with Acute Coronary Syndrome, and to correct pathway allocation.