Effect on emergency department efficiency of an accelerated diagnostic pathway for the evaluation of chest pain

Abstract

Objective: To compare ED efficiency measures between a trial period using an accelerated diagnostic pathway (ADP) for chest pain evaluation, and a control period using a traditional diagnostic pathway (TDP). Methods: The TDP used cardiac Troponin I assays at arrival and 6h. The ADP used point-of-care multimarker (myoglobin, creatine kinase-MB fraction and cardiac Troponin I) assays at arrival and 2h. Outcomes for consecutive eligible patients included ED length of stay (LOS), discharges and admissions within 4 and 8h, ED occupancy and cardiac cubicle throughput. Results: There were 413 and 258 eligible patients during the 81day TDP and 66day ADP periods. The ED LOS for chest pain patients wa..