Clinical effectiveness evaluation of an emergency department cardiac decision unit

Shalin S. Shah; Husam Noor; Glenn Tokarski; Nabil Khoury; Kristin B. McCabe; Keisha R. Sandberg; Robert J. Morlock; Peter A. McCullough

doi:10.1108/14664100110385532

Login

Welcome:
Guest

Search for:

Browse:

Product Information:

Resources:

British Journal of Clinical Governance

ISSN: 1466-4100
Currently published as: Clinical Governance: An International Journal
Incorporates: Clinical Performance and Quality Healthcare

Online from: 1996

Subject Area: Health Care Management/Healthcare

Content: Latest Issue | Latest Issue RSS | Previous Issues

Options: To add Favourites and Table of Contents Alerts please take a Emerald profile

Clinical effectiveness evaluation of an emergency department cardiac decision unit

Document Information:
Title:	Clinical effectiveness evaluation of an emergency department cardiac decision unit
Author(s):	Shalin S. Shah, (Henry Ford Health System, Detroit, Michigan, USA), Husam Noor, (Henry Ford Health System, Detroit, Michigan, USA), Glenn Tokarski, (Henry Ford Health System, Detroit, Michigan, USA), Nabil Khoury, (Henry Ford Health System, Detroit, Michigan, USA), Kristin B. McCabe, (Henry Ford Health System, Detroit, Michigan, USA), Keisha R. Sandberg, (Henry Ford Health System, Detroit, Michigan, USA), Robert J. Morlock, (Henry Ford Health System, Detroit, Michigan, USA), Peter A. McCullough, (Truman Medical Center, Kansas City, Missouri, USA)
Citation:	Shalin S. Shah, Husam Noor, Glenn Tokarski, Nabil Khoury, Kristin B. McCabe, Keisha R. Sandberg, Robert J. Morlock, Peter A. McCullough, (2001) "Clinical effectiveness evaluation of an emergency department cardiac decision unit", British Journal of Clinical Governance, Vol. 6 Iss: 1, pp.40 - 46
Keywords:	Clinical effectiveness, Clinical guidelines
Article type:	Research paper
DOI:	10.1108/14664100110385532 (Permanent URL)
Publisher:	MCB UP Ltd
Abstract:	The aim was to test the feasibility of using automated data, and evaluate the impact of an emergency cardiac decision unit (CDU) on the overall outcomes of patients seen for chest discomfort. We used a retrospective, quasi-experimental design to identify patients who had cardiac enzymes measured and an electrocardiogram performed during an ED visit in two six-month periods, pre-CDU (1 January-30 June 1995) and post-CDU (1 January- 30 June 1996). A total of 4,336 patients had outcomes assessed. After opening, 14.8 per cent of all chest pain cases were treated in the CDU. Hospital admission rates were reduced from 81.1 per cent to 66.7 per cent. Length of stay, myocardial infarction rates, and mortality were unchanged. The 14-day revisit rates increased from 5.3 per cent to 10.3 per cent. We conclude that cardiac decision units decrease hospital admissions but increase ED revisit rates as a consequence of this now frequently used care pathway.