TY - JOUR T1 - 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 JF - BMJ Quality Improvement Reports JO - BMJ Qual Improv Report DO - 10.1136/bmjquality.u206670.w2735 VL - 4 IS - 1 SP - u206670.w2735 AU - Judith Jade AU - Paul Huggan AU - Douglas Stephenson Y1 - 2015/01/01 UR - http://bmjopenquality.bmj.com/content/4/1/u206670.w2735.abstract N2 - 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. ER -