RT Journal Article
SR Electronic
T1 The impact of an acute chest pain pathway on the investigation and management of cardiac chest pain
JF Future Healthcare Journal
JO Future Healthc J
FD Royal College of Physicians
SP 53
OP 59
DO 10.7861/fhj.2019-0025
VO 7
IS 1
A1 Mark Sweeney
A1 Gillian Bleeze
A1 Sarah Storey
A1 Alexander Cairns
A1 Alexander Taylor
A1 Catherine Holmes
A1 Steve Hart
A1 Nick Lawrance
A1 William G Oldfield
A1 Christopher S Baker
YR 2020
UL http://www.rcpjournals.org/content/7/1/53.abstract
AB Emergency department (ED) presentation with chest pain accounts for approximately 20% of acute hospital admissions, and delays in the investigation and management of these patients increase the pressure on emergency and medical departments. We implemented a pathway within our trust to improve the efficiency of acute chest pain management. This included the development of a chest pain management algorithm, a short-stay heart assessment centre and a policy to immediately transfer acute coronary syndrome patients to cardiology. The introduction of the chest pain pathway resulted in fewer admissions from the ED with chest pain (34.2% vs 19.0%; p<0.0001), a reduction in time from ED attendance to cardiology transfer (9.3 hours vs 5.7 hours; p<0.0001) and a reduction in time to angiography (62.5 hours vs 26.6 hours; p<0.0001). Length of stay was reduced for cardiology patients (4.7 days vs 2.4 days, p<0.001) and mean length of stay for all patients attending ED with chest pain was reduced by 8.3 hours (27.5 hours vs 19.1 hours; p<0.0001). The changes have significantly improved the management of acute chest pain within our trust and we would suggest that adoption of these changes in other trusts could significantly improve the quality of the care for these patients throughout the NHS.