Implementation of the HEART Pathway in a Community Hospital

Admission rates decreased by 8% after implementation of a modified version of HEART that excluded patients with elevated troponin.

The HEART score — based on History, Electrocardiogram, Age, Risk factors, and Troponin level — is designed to guide decision making for patients with chest pain possibly of coronary etiology (NEJM JW Emerg Med Jun 2017 and Ann Intern Med 2017 Apr 25; [e-pub]), but its implementation in U.S. community emergency departments (EDs) has not been well studied. Investigators conducted a before-and-after study in a community ED to determine the effect of the HEART pathway on admission rates. Patients had chest pain of possible coronary origin, and providers were prompted by an electronic alert to use the HEART score in decision making. All patients with an initial troponin greater than the 99th percentile of normal were excluded, and most were admi…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Implementation of the HEART Pathway in a Community Hospital

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Reviewing Author