Reduced admission rates and resource utilization for chest pain patients using an electronic health record‐embedded clinical pathway in the emergency department
| Autor: | Foster R. Goss, Jasmeet S Dhaliwal, Melanie D Whittington, Kelly Bookman, Richard D. Zane, Jennifer L. Wiler, P. Michael Ho |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome chest pain Stress testing exercise test Chest pain Clinical decision support system clinical acute coronary syndrome Clinical pathway medicine critical pathways Myocardial infarction Original Research biology business.industry electronic health record Emergency department The Practice of Emergency Medicine medicine.disease Troponin myocardial infarction Emergency medicine biology.protein medicine.symptom business decision support systems |
| Zdroj: | Journal of the American College of Emergency Physicians Open |
| ISSN: | 2688-1152 |
| Popis: | Objectives Assess the impact of an electronic health record (EHR)‐embedded clinical pathway (ePATH) as compared to a paper‐based clinical decision support tool on outcomes for patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS). Methods A retrospective, quasi‐experimental study using difference‐in‐differences and interrupted time series specifications to evaluate the impact of an EHR‐embedded clinical pathway between April 2013 and July 2017. The intervention was implemented in February 2016 at a large academic tertiary hospital and compared to a local community hospital without the intervention. Eligible patients included adults (>18 years) presenting to the ED with chest pain who had a troponin ordered within 2 hours of arrival and a chest pain‐related diagnosis. Patients with initial evidence of acute myocardial infarction were excluded. Primary outcomes included rates of admission and stress testing, hospital length of stay, and occurrence of major adverse cardiac events. Results On average, there were 170 chest pain visits per month at the intervention site. The frequency of hospital admission (unadjusted 28.2% to 20.9%, P |
| Databáze: | OpenAIRE |
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