JACC Study: Chest Pain Center Accreditation Effective at Improving Care Process For ACS Patients

ACC's Chest Pain Center Accreditation
Journal of the American College of Cardiology

ACC's Chest Pain Center Accreditation may be effective at improving care processes for patients with suspected acute coronary syndrome (ACS), according to a study published May 11 in the Journal of the American College of Cardiology.

David E. Winchester, MD, MS, FACC, et al., described care delivery at 657 facilities prior to earning Chest Pain Center Accreditation to demonstrate improvements achieved through the accreditation.

Using data from facilities earning Chest Pain Center Accreditation between 2014 and 2019, the authors looked at 66 of 244 essential components that are mandatory for all sites to achieve accreditation.

The 66 components analyzed were chosen based on their alignment with the quadruple aim of improved outcomes, patient experience and clinical care and lower costs. Facilities were categorized as rural, suburban or urban; teaching vs. nonteaching; and hospital size.

According to the results, 48.8% of facilities were teaching hospitals and 51.1% were nonteaching. Urban institutions accounted for 69.5% of participating institutions.

Before earning accreditation, compliance with essential components ranged from a low of 14.3% for a process to perform a follow-up stress test within 72 hours to 78.7% for external signage that communicates direction access to the emergency department (ED).

Of the 66 essential components, there were no significant differences in compliance based on facility size; however, there were differences based on teaching vs. nonteaching status.

Urban facilities (57.5%) were more likely to collaborate with emergency medical services on accuracy of field STEMI activation vs. rural (31.7%) or suburban (47.1%) institutions.

In addition, urban hospitals were more likely to have a 10-minute goal for presentation-to-electrocardiogram time, to have a single contact point for the catheterization laboratory, and to give ED clinicians STEMI activation authority.

Teaching hospitals were more likely to offer both external and internal health assessments vs. nonteaching hospitals (49.8% vs. 34.9% for external and 48.3 vs. 31.0% for internal). Rural hospitals were less likely to provide internal health screenings (15%), compared with suburban (41.2%) and urban (42.7%) hospitals.

In addition, 36.7% of rural hospitals identified physician champions for cardiology vs. 50% of suburban hospitals and 64.5% of urban hospitals.

According to the authors, many hospitals had gaps in care processes for the essential components aligning with the quadruple aim that must be addressed "with 100% compliance" before the facility can achieve accreditation.

"As such, ACC Chest Pain Center Accreditation may be an effective mechanism for improving processes of care for patients with suspected ACS," they conclude.

Clinical Topics: Acute Coronary Syndromes, Stable Ischemic Heart Disease, Vascular Medicine, Chronic Angina

Keywords: Hospitals, Rural, Health Facility Size, ST Elevation Myocardial Infarction, Acute Coronary Syndrome, Hospitals, Urban, Hospitals, Teaching, Emergency Service, Hospital, Accreditation, Catheterization, Electrocardiography, National Cardiovascular Data Registries

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