Chest Pain Center FAQs
As a benefit to facilities that utilize an ACC Accreditation product, our Accreditation Specialists have conducted occasional "Ask the Experts" webinars.
Our accreditation experts have also posted the answers to several frequently asked questions about a number of important healthcare and related accreditation topics.
If you are a current customer and require support for your Accreditation tool(s), or have questions about the Accreditation process, please contact us using the Contact Us Form.
If you have questions about any of our Accreditation or Certification programs, please email us at firstname.lastname@example.org.
Tracey Blevins, MBA-HCM, BSN, RN, AACC
Accreditation Clinical Product Manager
FAQ: Chest Pain Center Accreditation and Data Collection
A: Facilities have three options for collecting data:
1. Submit all patient records into the Accreditation Conformance Database (ACD). The ACD is the data repository housed in the CPC Accreditation tool which enables ongoing reporting of collected metrics to gauge progress toward meeting established goals
2. Submit all patient records into the NCDR® Chest Pain-MI Registry™
3. Submit all AMI (STEMI, NSTEMI, and Resuscitation (if applicable)) patients into the Chest Pain-MI Registry™ and all Low-Risk and Unstable Angina patients into the ACD. This is a hybrid approach to data collection made available to participants in the Chest Pain-MI Registry
By providing these three methods, facilities have the flexibility to choose which words best for their program
A: The latest version continues to build on the foundation of previous iterations of Chest Pain Center Accreditation, further raising the bar and ensuring the most current guidelines are reflected in the tool requirements. It also continues to add additional recommended and innovative items for hospitals who choose to further move their facilities forward.
Greater Focus on ROI
The latest version further expands the financial benefits of establishing or improving a facilities chest pain program while ensuring quality care is rendered with limited variation.
Expanded Focus on the Low-Risk chest pain patient in an Observation Status
The latest version now includes a section on the treatment of the Low-Risk patient placed in Observation. This section provides guidance on reducing LOS, increasing revenue, reducing costly delays, and improving patient satisfaction and safety. These favorably impact ED throughput by accelerating bed turnover.
Seamless integration with the CP-MI Registry to reduce the data burden for participants
A new "Quality" Essential Component (EC)
This new EC consolidates mandatory requirements centered around process improvement efforts. Quality is the cornerstone requirement to integrate continuous improvement in all aspects of care. These include the development of a Quality Assurance Performance Improvement plan, alignment with overall organization strategic goals, recognition, and treatment strategies for potential and known Acute Coronary Syndrome patients, and case reviews.
An accelerated pathway to accreditation is available to facilities who have earned a silver, gold, or platinum CP-MI Registry Performance Achievement Award
A: The vision for the ACS service line is to extend the focus beyond STEMI patients and help hospitals improve the care of the NSTE-ACS (NSTEMI and UA) and LOW-RISK patient populations. In most cases, these processes seem to be less defined. The LOW-RISK population accounts for 80% of the chest pain patient volume. Our accreditation tool guides hospitals in building hardwired protocols and pathways to efficiently risk stratify and manage these patients. Research shows not all Low-Risk chest pain patients require provocative testing or observation services. Implementing appropriate risk stratification for identification of those at sufficient risk of an acute event will better guide clinical decision making, along with disposition and stress testing options. These should always be coupled with shared decision making with the patient. There is a great focus to minimize the variability between providers and improve the utilization of resources to reduce costs while elevating the delivery of care.
A: STEMI patients are the most critical upon presentation. They are the quintessential emergency. Hospitals have done an amazing job at building solid processes to facilitate reperfusion of the culprit lesion. With a NSTEMI, the patient is still having a heart attack but has not progressed to a STEMI yet. The UA patient is displaying signs and symptoms of a heart attack but it is not evident on the ECG or cardiac biomarker (Troponin). Often the plan of care remains variable, dependent upon such factors such as the time of day, day of the week, risk stratification method, provider-dependent strategy, hospital resources, etc. Accreditation frequently reveals these variabilities and assists hospitals in developing pre-determined pathways to ensure the right care is delivered at the right time to the right patient. The guidelines are out there, but hospitals continue to struggle with operationalizing the science. For the Low-Risk patient care, pathways are even less well-defined, yet this group reflects the majority of the volume which brings a huge liability.
A: The Low-Risk population is an ongoing challenge. Despite an array of diagnostic modalities and strategies, there remains this task to appropriately identify those patients who require extended work-up or rule-out versus those who can safely be discharged from the ED. Failure to detect a patient with ACS and inadvertently discharging them can result not only in harm to the patient, but significant liability to the provider and hospital. On the other hand, patients not at high risk of having an acute event who are inappropriately admitted and undergo expensive evaluations set the facility up for extended lengths of stay, inappropriate resources utilization, avoidable costs, and decreased patient satisfaction. ACC Accreditation Services plays a vital role in setting the standard of care for the Low-Risk patient. By taking science to the bedside™ through the accreditation tool, facilities are given a road map to guide them in delivering evidence-based care. By collecting performance and outcomes data, we can demonstrate the impact our tool has on the components of value-based purchasing and reimbursement programs.
A: Data for the Chest Pain - MI Registry™ is entered and submitted on a quarterly basis, although it is only requested monthly for Chest Pain Center Accreditation and Certification. Concurrent data entry will give the best results as you can get real time metrics to monitor your facility's processes such as door-to-ECG time and door-in-door-out (DIDO). On average, it takes a seasoned data abstractor about 10-15 minutes for a Low-Risk case, 30-40 minutes for a NSTEMI case, and 20-30 minutes for a STEMI case in the basic data set. The more you do it, the faster you become. Once you enter data, there is a simple process to submit and each Monday you will be able to see your facility's dashboard. You can also see how you compare to hospitals of a similar size.
For Chest Pain Center Certification customers, the anticipated time and effort will be much lower than a tertiary facility. The patient volume and applicable data points collected for Critical Access Hospitals and FreeStanding Emergency Departments will be measurably less. Participating in this registry will provide your facility with quality metrics for each population, allowing you to keep a pulse on quality to identify areas of process improvement.
FAQ: Management of the Chest Pain Observation Patient
Less crowding in the ED
Improved patient satisfaction
Lower cost of care
Maximizes revenue opportunities
Increased through-put times