Additional cardiac imaging often unnecessary
Last week, Mayo Clinic researchers showed that using a shared decision-making aid to involve more patients in care decisions can prevent both unnecessary hospitalization and more advanced cardiac tests for patients with low-risk chest pain.
The "Chest Pain Choice" shared decision-making aid is one of the latest evidence-based practices built on high-sensitivity troponin rule-out of acute coronary syndrome for ED patients reporting acute chest pain. After the one-hour test, an additional "one minute" discussion to educate patients about their risk and reach a shared decision can prevent further unnecessary and costly testing.
ACVP Blog has discussed decision-making for acute chest pain before, suggesting that the fact the cardiac biomarker test can safely and accurately rule-out acute coronary syndrome within one hour "challenges [the] need" for commonly-used noninvasive imaging prior to patient discharge.
Continue reading One Minute, Shared Decision-Making Aid Reduces Unnecessary Hospitalization
Despite relatively few strong research studies supporting methodologies for improving adherence to medications for patients with heart failure, Medtronic's recent press release suggests their cardiac resynchronization therapy (CRT) implants might do the trick.
Medtronic accounced results of a retrospective analysis of administrative claims data of more than 4,500 patients with heart failure at the 2016 Heart Failure Society of America Scientific Meeting, Monday.
The analysis found that the number of patients "fully compliant" to a regimen of guideline-recommended medications "nearly doubled" at twelve months following CRT implants compared to those who did not receive implants.
Continue reading Improving adherence to medications for heart failure: Medtronic says their CRT does it
"One of the most extensive recommendations in the consensus statement," writes the Advisory Board Company's Jake Hartman on a consensus statement released by cardiology leaders in a 2012 edition of Catheterization and Cardiovascular Interventions, "the group recommends that hospitals develop a detailed preprocedure checklist to ensure all safety precautions appropriate for the cath lab have been taken."
In December of 2009, Atul Gawande, MD released a book called A Checklist Manifesto, a strong argument for the use of pre-procedure checklists in medicine and other fields.
Continue reading Essential Characteristic #3 – Experts Need Checklists