Frank Breuckmann1, Matthias Hochadel2, Armin J Grau3, Evangelos Giannitsis4, Thomas Münzel5, Jochen Senges2. 1. Department of Cardiology, Herz-Jesu-Krankenhaus Dernbach, Südring 8, 56428, Dernbach, Germany. f.breuckmann@krankenhaus-dernbach.de. 2. Institute for Myocardial Infarction Research Foundation Ludwigshafen, University of Heidelberg, Heidelberg, Germany. 3. Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen am Rhein, Germany. 4. Department of Internal Medicine III, Heidelberg University Hospital, Heidelberg, Germany. 5. Cardiology I, Center for Cardiology, University Medical Center Mainz, Mainz, Germany.
Abstract
BACKGROUND: Chest pain units (CPUs) and stroke units (SUs) provide specialized multidisciplinary in-hospital management for acute chest pain and ischemic stroke. We analyzed exemplary equivalent quality benchmarks in both concepts. MATERIAL AND METHODS: Data from the German CPU registry (2012-2015; 45 certified CPUs, 5881 patients) were compared with data from the SU registry of Rhineland-Palatinate (2011-2015; 29 SUs; 40,380 patients). Parameters comprised demographics, symptoms, diagnosis, medication, critical time intervals, therapeutics, and in-unit outcome. RESULTS: Non-ST-segment elevation myocardial infarction (47.4%) and ischemic stroke (63.0%) were the most frequent entities. An electrocardiogram was performed on average within 7 min in CPUs, cranial imaging within 49 min in SUs. The mean time interval from admission until coronary intervention or lysis was 42 min or 57 min, respectively. Rates of antiplatelet therapy (90.1% vs. 96.0%), brain imaging, and coronary angiography were high (99.3% vs. 81.1%) and the mortality was low (0.8% for CPUs vs. 3.6% for SUs). The length of stay was shorter in CPUs (1.5 days vs. 4.4 days). CONCLUSION: As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged.
BACKGROUND: Chest pain units (CPUs) and stroke units (SUs) provide specialized multidisciplinary in-hospital management for acute chest pain and ischemic stroke. We analyzed exemplary equivalent quality benchmarks in both concepts. MATERIAL AND METHODS: Data from the German CPU registry (2012-2015; 45 certified CPUs, 5881 patients) were compared with data from the SU registry of Rhineland-Palatinate (2011-2015; 29 SUs; 40,380 patients). Parameters comprised demographics, symptoms, diagnosis, medication, critical time intervals, therapeutics, and in-unit outcome. RESULTS: Non-ST-segment elevation myocardial infarction (47.4%) and ischemic stroke (63.0%) were the most frequent entities. An electrocardiogram was performed on average within 7 min in CPUs, cranial imaging within 49 min in SUs. The mean time interval from admission until coronary intervention or lysis was 42 min or 57 min, respectively. Rates of antiplatelet therapy (90.1% vs. 96.0%), brain imaging, and coronary angiography were high (99.3% vs. 81.1%) and the mortality was low (0.8% for CPUs vs. 3.6% for SUs). The length of stay was shorter in CPUs (1.5 days vs. 4.4 days). CONCLUSION: As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged.
Authors: Silke Wiedmann; Peter U Heuschmann; Steffi Hillmann; Otto Busse; Horst Wiethölter; Georg M Walter; Günter Seidel; Björn Misselwitz; Alfred Janssen; Klaus Berger; Christoph Burmeister; Christine Matthis; Peter Kolominsky-Rabas; Peter Hermaneks Journal: Dtsch Arztebl Int Date: 2014-11-07 Impact factor: 5.594
Authors: Mehrshad Vafaie; Matthias Hochadel; Thomas Münzel; Birgit Hailer; Burghard Schumacher; Gerd Heusch; Thomas Voigtländer; Harald Mudra; Michael Haude; Sebastian Barth; Claus Schmitt; Harald Darius; Lars S Maier; Hugo A Katus; Jochen Senges; Evangelos Giannitsis Journal: Eur Heart J Acute Cardiovasc Care Date: 2018-03-15