Disposition for Adult Patients Presenting with Chest Pain

Abstract

Many small community hospitals may have limited cardiology services. Subsequently, family medicine and internal medicine providers often construct the disposition of adult patients which present with chest pain. The purpose of this project is to review available evidence related to disposition of adult patients that acutely present with chest pain and to implement a quality improvement project to enhance clinical decisions making of providers. According to findings of an informal survey of eleven providers in a small community hospital, providers did not follow any published guidelines or risk stratification regarding the disposition of adult patients with chest pain admitted to the emergency department (ED). A tool based on the HEART Score was incorporated into the electronic health record (EHR) to tabulate risk and formulate recommendations for providers when treating an adult patient with chest pain. The tool was implemented and was evaluated through the performance improvement process. Such tools have the potential of expediting the disposition of adult patients with chest pain while providing an evidenced based structure for providers.