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 6 h. The ADP used point-of-care multimarker (myoglobin, creatine kinase-MB fraction and cardiac Troponin I) assays at arrival and 2 h. Outcomes for consecutive eligible patients included ED length of stay (LOS), discharges and admissions within 4 and 8 h, ED occupancy and cardiac cubicle throughput. RESULTS: There were 413 and 258 eligible patients during the 81 day TDP and 66 day ADP periods. The ED LOS for chest pain patien..