HEART Pathway Implementation
Acute Coronary Syndrome
Chest Pain Atypical Syndrome
Chest Pain Rule Out Myocardial Infarction
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||The HEART Pathway: Bridging the Gap Between Operations, Research, and Education|
- Hospitalization rate [ Time Frame: 30 Days after Emergency Department Visit ]
|Actual Study Start Date:||November 2013|
|Estimated Study Completion Date:||September 2017|
|Estimated Primary Completion Date:||July 2017 (Final data collection date for primary outcome measure)|
Post-HEART Pathway Implementation
Data will be collected on patients presenting to the Emergency Department (ED) with chest pain after implementation of the HEART Pathway decision aid.
Pre-HEART Pathway Implementation
Data will be collected on patients presenting to the Emergency Department (ED) with chest pain prior to Implementation of the HEART Pathway decision aid.
Millions of patients with chest pain are seen in Emergency Departments (EDs) every year. Over half of ED patients with chest pain are admitted to the hospital to undergo further testing. Despite high testing rates, less than 1 in 10 patients with chest pain are ultimately diagnosed with an acute coronary syndrome (ACS) at estimated annual cost of $13 billion. Current care patterns for acute chest pain fail to focus health system resources, such as hospitalization and cardiac testing, on patients most likely to benefit.
The HEART Pathway, which combines a clinical decision aid, with two serial troponin measurements, has been developed to identify patients with chest pain who can safely be discharged without objective cardiac testing (stress testing or angiography). Prior retrospective and observational studies have established that use of the HEART Pathway reduces cardiac testing by >20%, while maintaining an acceptably low adverse event rate. We now seek to integrate the HEART Pathway into "real-world" clinical settings to determine effectiveness.
The goal of this proposal is to build a transformative collaboration bridging the gap between research, education, and health systems operations to more effectively and efficiently provide patient care. The vanguard for this collaboration seeks to improve quality of care for patients with acute chest pain by integrating the HEART Pathway into cardiovascular care delivery at Wake Forest Baptist Health (WFBH). This project will build on our prior work and provide a model for using the education and operational strengths of US academic medical centers to disseminate initiatives to improve care delivery.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02056964
|United States, North Carolina|
|Wake Forest Baptist Medical Center|
|Winston-Salem, North Carolina, United States, 27157|
|Principal Investigator:||Simon A Mahler, MD, MS||Wake Forest Baptist Medical Center|