HEART Pathway Implementation
| Status: | Completed |
|---|---|
| Conditions: | Angina, Cardiology, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 3/6/2019 |
| Start Date: | November 2013 |
| End Date: | January 31, 2019 |
The HEART Pathway: Bridging the Gap Between Operations, Research, and Education
The purpose of this study is to determine the effectiveness of the HEART Pathway, a clinical
decision aid for the care of patients with chest pain, in a "real-world" clinical setting.
This will be accomplished through the building of a transformative collaboration between
research, education, and health systems operations to more effectively and efficiently
provide patient care.
decision aid for the care of patients with chest pain, in a "real-world" clinical setting.
This will be accomplished through the building of a transformative collaboration between
research, education, and health systems operations to more effectively and efficiently
provide patient care.
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.
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.
Inclusion Criteria:
- Age greater than or equal to 21 years of age at the time of Emergency Department (ED)
visit
- Chest discomfort consistent with possible Acute Coronary Syndrome (ACS) as indicated
by the treating physician obtaining an Electrocardiogram (ECG) and cardiac biomarkers
for the patient's evaluation.
Exclusion Criteria:
- New ST-segment elevation in contiguous leads on any electrocardiogram (>/= 1 mV)
We found this trial at
1
site
Winston-Salem, North Carolina 27157
Principal Investigator: Simon A Mahler, MD, MS
Phone: 336-716-2059
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