Article Text

Who gets admitted to the Chest Pain Unit (CPU) and how do we manage them? Improving the use of the CPU in Waikato DHB, New Zealand
  1. Judith Jade,
  2. Paul Huggan,
  3. Douglas Stephenson
  1. Waikato DHB, New Zealand
  1. Correspondence to
    Judith Jade judithjade{at}gmail.com

Abstract

Chest pain is a commonly encountered presentation in the emergency department (ED). The chest pain unit at Waikato DHB is designed for patients with likely stable angina, who are at low risk of acute coronary syndrome (ACS), with a normal ECG and Troponin T, who have a history which is highly suggestive of coronary artery disease (CAD). Two issues were identified with patient care on the unit (1) the number of inappropriate admissions and (2) the number of inappropriate exercise tolerance tests.

A baseline study showed that 73% of admissions did not fulfil the criteria and the majority of patients (72%) had an exercise tolerance test (ETT) irrespective of clinical picture. We delivered educational presentations to key stakeholders and the implementation of a new fast track chest pain pathway for discharging patients directly from the ED. There was an improvement in the number of patients inappropriately admitted, which fell to 61%. However, the number of inappropriate ETTs did not decrease, and were still performed on 76.9% of patients.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See:

View Full Text

Statistics from Altmetric.com

Supplementary materials

  • Supplementary Material for Who gets admitted to the Chest Pain Unit (CPU) and how do we manage them? Improving the use of the CPU in Waikato DHB, New Zealand

    Extra information supplied by the author

    Files in this Data Supplement:

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.