Implementing a clinical pathway for the treatment of Medicare patients with cardiac chest pain.

摘要: BACKGROUND A small urban hospital identified angina pectoris (DRG 140) as a high-cost and low-reimbursement DRG. Variation in the process of care for patients with cardiac chest pain was related to timing decisions on stress tests whether inpatient GI workups were performed. Underutilization aspirin quality issue. In collaboration Texas Medical Foundation (TMF), Quality Improvement Organization (QIO) Texas, this became initial Health Care Program (HCQIP) project first effort by at pathway development. INTERVENTION team lead physicians, including other healthcare groups hospital, elements considered essential providing ideal pain, formulating these into clinical pathway. RESULTS Emergency room an stakeholder group, had not been included development, which proved be critical factor effective implementation. Pathway implementation associated increased administration 45.7% (p < 0.001), reduced length stay 1.0 days = 0.064), total charges average $1710.20 0.039). DISCUSSION These results suggest that improvement, i.e., implementation, QIO, contributed variation care. Participation all stakeholders from beginning improvement is essential.