We have a couple different pathways called CCC's which I think stands for Collaborative Care Continuim (sp). There is one for low risk MI and one for hi risk MI. In ED they do MONA, serial EKG's, cardiac profiles, etc. Within 30 min. of arrival. Once on the floor, if doc continues the CCC (most do) he orders the type of stress he wants for the next day, that is if profiles are neg, also nitropaste, lipid profile, EKG in AM, etc. are all on the pathway. (These are all just check marks on a list.) If profiles are pos they fall off that pathway and go to ACS pathway at Dr's discretion, which has things on it like integrillin, Lovenox, IV nitro, echo. There's room, of course, for the Dr to modify so they're not feeling like it's cookbook medicine. A lot of these things are national reportable indicators though and our hospital developed these pathways for that reason. In fact there was a guy at Harvard University who, this year, was doing a paper on quality care and our hospital came up in his research. He ended up doing his paper on us
We are the top hospital in Indiana due directly to developing these pathways. Here is the link to our hospital's feedback from that paper. There was a big write up in our local paper too about the same time, but I can't get the wording right to find the archived article. http://www.reidhosp.com/news/release...0214-best.html
Our hospital also hired people to do chart review to make sure nothing was missed and to do Pt call backs.