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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 accreditationinfo@acc.org.

    Tracey Blevins, MBA-HCM, BSN, RN, AACC

    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

    A. What can we expect upon implementing the recommendations found in the CPC Accreditation tool?

    Reduced LOS
    Less crowding in the ED
    Fewer diversions
    Improved patient satisfaction
    Lower cost of care
    Maximizes revenue opportunities
    Increased through-put times
    A. Added to the tool is a new section dedicated to Chest Pain Observation patients that provides guidance and best practices leading to better results. Implementing many of the items/recommendations within the tool have been shown to result in sustainable improvements. 
    A.  Facilities will be able to track Observation-related data such as length of stay and Observation to inpatient conversions on an ongoing basis to measure improvements when care processes are implemented.
    A. Our Accreditation Review Specialists, serving as consultants during the application process, are experts in process improvement initiatives, including those surrounding Observational care.  This expertise is provided at no additional cost to facilities as part of our mission to improve cardiac care. There is no other organization that provides this level of assistance as part of their accreditation program.
    A. The tool has expanded to include more best practices found to improve the delivery of Observational care. The Essential Components will provide hospitals with an educational framework for clinicians, identification of appropriate Observation patient populations, ways to improve the handoff process, and methods to lower costs. Most importantly, within the Essential Components will be found better methods to demonstrate more succinctly the financial data surrounding the cost of excessive lengths of stay and unnecessary testing. This information in vital in finding support when process changes are needed.  
    A. Medicare reports an ever-increasing number of patients placed in Observation, and therefore developing and implementing a financially sound unit becomes increasingly important.  Although Medicare does not specify where an Observation unit is located, there are important benefits to the establishment of a specific, dedicated unit that can focus on shortening length of stay, providing better patient outcomes and satisfaction, and lowering the overall cost of care.  

    ACC Accreditation Services is Your Partner for QI

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