Critical pathways for management of patients with acute coronary syndromes: An assessment by the National Heart Attack Alert Program
Background The use of critical pathways for a variety of clinical conditions has grown rapidly in recent years, particularly pathways for patients with acute coronary syndromes (ACS). However, no systematic review exists regarding the value of critical pathways in this setting. Methods The National...
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| Veröffentlicht in: | The American heart journal 2002-05, Vol.143 (5), p.777-789 |
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| creator | Cannon, Christopher P Hand, Mary H Bahr, Raymond Boden, William E Christenson, Robert Gibler, W Brian Eagle, Kim Lambrew, Costas T Lee, Thomas H MacLeod, Bruce Ornato, Joseph P Selker, Harry P Steele, Pamela Zalenski, Robert J |
| description | Background The use of critical pathways for a variety of clinical conditions has grown rapidly in recent years, particularly pathways for patients with acute coronary syndromes (ACS). However, no systematic review exists regarding the value of critical pathways in this setting. Methods The National Heart Attack Alert Program established a Working Group to review the utility of critical pathways on quality of care and outcomes for patients with ACS. A literature search of MEDLINE, cardiology textbooks, and cited references in any article identified was conducted regarding the use of critical pathways for patients with ACS. Results Several areas for improving the care of patients with ACS through the application of critical pathways were identified: increasing the use of guideline-recommended medications, targeting use of cardiac procedures and other cardiac testing, and reducing the length of stay in hospitals and intensive care units. Initial studies have shown promising results in improving quality of care and reducing costs. No large studies designed to demonstrate an improvement in mortality or morbidity were identified in this literature review. Conclusions Critical pathways offer the potential to improve the care of patients with ACS while reducing the cost of care. Their use should improve the process and cost-effectiveness of care, but further research in this field is needed to determine whether these changes in the process of care will translate into improved clinical outcomes. (Am Heart J 2002;143:777-89.) |
| doi_str_mv | 10.1067/mhj.2002.120260 |
| format | Article |
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However, no systematic review exists regarding the value of critical pathways in this setting. Methods The National Heart Attack Alert Program established a Working Group to review the utility of critical pathways on quality of care and outcomes for patients with ACS. A literature search of MEDLINE, cardiology textbooks, and cited references in any article identified was conducted regarding the use of critical pathways for patients with ACS. Results Several areas for improving the care of patients with ACS through the application of critical pathways were identified: increasing the use of guideline-recommended medications, targeting use of cardiac procedures and other cardiac testing, and reducing the length of stay in hospitals and intensive care units. Initial studies have shown promising results in improving quality of care and reducing costs. No large studies designed to demonstrate an improvement in mortality or morbidity were identified in this literature review. Conclusions Critical pathways offer the potential to improve the care of patients with ACS while reducing the cost of care. Their use should improve the process and cost-effectiveness of care, but further research in this field is needed to determine whether these changes in the process of care will translate into improved clinical outcomes. (Am Heart J 2002;143:777-89.)</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1067/mhj.2002.120260</identifier><identifier>PMID: 12040337</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Acute Disease ; Angina, Unstable - diagnosis ; Angina, Unstable - therapy ; Anticoagulants - therapeutic use ; Aspirin - therapeutic use ; Biological and medical sciences ; Cardiology. Vascular system ; Clinical Trials as Topic ; Colleges & universities ; Coronary Care Units ; Coronary heart disease ; Critical Pathways - classification ; Critical Pathways - standards ; Emergency medical care ; Heart ; Heart attacks ; Hospitals ; Humans ; Length of Stay ; Medical sciences ; Myocardial Infarction - diagnosis ; Myocardial Infarction - therapy ; Syndrome ; Thrombolytic Therapy - standards</subject><ispartof>The American heart journal, 2002-05, Vol.143 (5), p.777-789</ispartof><rights>2002 Mosby, Inc.</rights><rights>2002 INIST-CNRS</rights><rights>Copyright Elsevier Limited May 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-581daadd07f0f862104b1aaf9b34b82fe97688f8663999f30d8c445d953173fd3</citedby><cites>FETCH-LOGICAL-c442t-581daadd07f0f862104b1aaf9b34b82fe97688f8663999f30d8c445d953173fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870302187849$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13701479$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12040337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cannon, Christopher P</creatorcontrib><creatorcontrib>Hand, Mary H</creatorcontrib><creatorcontrib>Bahr, Raymond</creatorcontrib><creatorcontrib>Boden, William E</creatorcontrib><creatorcontrib>Christenson, Robert</creatorcontrib><creatorcontrib>Gibler, W Brian</creatorcontrib><creatorcontrib>Eagle, Kim</creatorcontrib><creatorcontrib>Lambrew, Costas T</creatorcontrib><creatorcontrib>Lee, Thomas H</creatorcontrib><creatorcontrib>MacLeod, Bruce</creatorcontrib><creatorcontrib>Ornato, Joseph P</creatorcontrib><creatorcontrib>Selker, Harry P</creatorcontrib><creatorcontrib>Steele, Pamela</creatorcontrib><creatorcontrib>Zalenski, Robert J</creatorcontrib><creatorcontrib>National Heart Attack Alert Program (NHAAP) Coordinating Committee Critical Pathways Writing Group</creatorcontrib><title>Critical pathways for management of patients with acute coronary syndromes: An assessment by the National Heart Attack Alert Program</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background The use of critical pathways for a variety of clinical conditions has grown rapidly in recent years, particularly pathways for patients with acute coronary syndromes (ACS). However, no systematic review exists regarding the value of critical pathways in this setting. Methods The National Heart Attack Alert Program established a Working Group to review the utility of critical pathways on quality of care and outcomes for patients with ACS. A literature search of MEDLINE, cardiology textbooks, and cited references in any article identified was conducted regarding the use of critical pathways for patients with ACS. Results Several areas for improving the care of patients with ACS through the application of critical pathways were identified: increasing the use of guideline-recommended medications, targeting use of cardiac procedures and other cardiac testing, and reducing the length of stay in hospitals and intensive care units. Initial studies have shown promising results in improving quality of care and reducing costs. No large studies designed to demonstrate an improvement in mortality or morbidity were identified in this literature review. Conclusions Critical pathways offer the potential to improve the care of patients with ACS while reducing the cost of care. Their use should improve the process and cost-effectiveness of care, but further research in this field is needed to determine whether these changes in the process of care will translate into improved clinical outcomes. (Am Heart J 2002;143:777-89.)</description><subject>Acute coronary syndromes</subject><subject>Acute Disease</subject><subject>Angina, Unstable - diagnosis</subject><subject>Angina, Unstable - therapy</subject><subject>Anticoagulants - therapeutic use</subject><subject>Aspirin - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Clinical Trials as Topic</subject><subject>Colleges & universities</subject><subject>Coronary Care Units</subject><subject>Coronary heart disease</subject><subject>Critical Pathways - classification</subject><subject>Critical Pathways - standards</subject><subject>Emergency medical care</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Medical sciences</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - therapy</subject><subject>Syndrome</subject><subject>Thrombolytic Therapy - standards</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kc-LEzEUx4Mobnf17E0C4t6mm18zmXgrRV1hUQ96Dml-bFNnJjXJuPTuH-6rLSwInpLH-3wfyfsg9IqSJSWdvBm3uyUjhC0pI6wjT9CCEiWbTgrxFC0IdJpeEn6BLkvZQdmxvnuOLoAWhHO5QL_XOdZozYD3pm4fzKHgkDIezWTu_einilM4tiJcC36IdYuNnavHNuU0mXzA5TC5nEZf3uHVhE0pvpS_wc0B163HnyEM5IBvvckVr2o19gdeDR6KrzndZzO-QM-CGYp_eT6v0PcP77-tb5u7Lx8_rVd3jRWC1abtqTPGOSIDCX3HKBEbakxQGy42PQteya7vodNxpVTgxPUQbJ1qOZU8OH6Frk9z9zn9nH2peozF-mEwk09z0ZLKTrayBfDNP-AuzRk-UTRtiWgFU5QBdXOibE6lZB_0PscRdqIp0Uc9GvToox590gOJ1-e582b07pE_-wDg7RkwBaSEbCYbyyPHJaFCKuDUifOwrl_RZ10sKLLexext1S7F_z7iD_82q_Q</recordid><startdate>20020501</startdate><enddate>20020501</enddate><creator>Cannon, Christopher P</creator><creator>Hand, Mary H</creator><creator>Bahr, Raymond</creator><creator>Boden, William E</creator><creator>Christenson, Robert</creator><creator>Gibler, W Brian</creator><creator>Eagle, Kim</creator><creator>Lambrew, Costas T</creator><creator>Lee, Thomas H</creator><creator>MacLeod, Bruce</creator><creator>Ornato, Joseph P</creator><creator>Selker, Harry P</creator><creator>Steele, Pamela</creator><creator>Zalenski, Robert J</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20020501</creationdate><title>Critical pathways for management of patients with acute coronary syndromes: An assessment by the National Heart Attack Alert Program</title><author>Cannon, Christopher P ; Hand, Mary H ; Bahr, Raymond ; Boden, William E ; Christenson, Robert ; Gibler, W Brian ; Eagle, Kim ; Lambrew, Costas T ; Lee, Thomas H ; MacLeod, Bruce ; Ornato, Joseph P ; Selker, Harry P ; Steele, Pamela ; Zalenski, Robert J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-581daadd07f0f862104b1aaf9b34b82fe97688f8663999f30d8c445d953173fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Acute coronary syndromes</topic><topic>Acute Disease</topic><topic>Angina, Unstable - diagnosis</topic><topic>Angina, Unstable - therapy</topic><topic>Anticoagulants - therapeutic use</topic><topic>Aspirin - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cardiology. 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Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cannon, Christopher P</au><au>Hand, Mary H</au><au>Bahr, Raymond</au><au>Boden, William E</au><au>Christenson, Robert</au><au>Gibler, W Brian</au><au>Eagle, Kim</au><au>Lambrew, Costas T</au><au>Lee, Thomas H</au><au>MacLeod, Bruce</au><au>Ornato, Joseph P</au><au>Selker, Harry P</au><au>Steele, Pamela</au><au>Zalenski, Robert J</au><aucorp>National Heart Attack Alert Program (NHAAP) Coordinating Committee Critical Pathways Writing Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Critical pathways for management of patients with acute coronary syndromes: An assessment by the National Heart Attack Alert Program</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2002-05-01</date><risdate>2002</risdate><volume>143</volume><issue>5</issue><spage>777</spage><epage>789</epage><pages>777-789</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background The use of critical pathways for a variety of clinical conditions has grown rapidly in recent years, particularly pathways for patients with acute coronary syndromes (ACS). However, no systematic review exists regarding the value of critical pathways in this setting. Methods The National Heart Attack Alert Program established a Working Group to review the utility of critical pathways on quality of care and outcomes for patients with ACS. A literature search of MEDLINE, cardiology textbooks, and cited references in any article identified was conducted regarding the use of critical pathways for patients with ACS. Results Several areas for improving the care of patients with ACS through the application of critical pathways were identified: increasing the use of guideline-recommended medications, targeting use of cardiac procedures and other cardiac testing, and reducing the length of stay in hospitals and intensive care units. Initial studies have shown promising results in improving quality of care and reducing costs. No large studies designed to demonstrate an improvement in mortality or morbidity were identified in this literature review. Conclusions Critical pathways offer the potential to improve the care of patients with ACS while reducing the cost of care. Their use should improve the process and cost-effectiveness of care, but further research in this field is needed to determine whether these changes in the process of care will translate into improved clinical outcomes. (Am Heart J 2002;143:777-89.)</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12040337</pmid><doi>10.1067/mhj.2002.120260</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute coronary syndromes Acute Disease Angina, Unstable - diagnosis Angina, Unstable - therapy Anticoagulants - therapeutic use Aspirin - therapeutic use Biological and medical sciences Cardiology. Vascular system Clinical Trials as Topic Colleges & universities Coronary Care Units Coronary heart disease Critical Pathways - classification Critical Pathways - standards Emergency medical care Heart Heart attacks Hospitals Humans Length of Stay Medical sciences Myocardial Infarction - diagnosis Myocardial Infarction - therapy Syndrome Thrombolytic Therapy - standards |
| title | Critical pathways for management of patients with acute coronary syndromes: An assessment by the National Heart Attack Alert Program |
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