Safe Discharge for Adults with Low Risk Chest Pain

Patients with chest pain commonly seek care in the emergency department. Chest pain can be tied to numerous diagnoses, ranging widely in severity, type, and urgency of treatment. The most severe cases may require an immediate intervention and admission to the hospital. Many cases, however, can be identified using evidence-based guidelines to be of low risk and therefore can be managed within the emergency department before being safely discharged home. Within MEDIC, we measure clinical performance on this quality initiative using the HEAR+T pathway, which has been rigorously tested and shown to appropriately identify chest pain patients who can safely be discharged home. This clinical decision tool takes into account the patient’s history, EKG, age, risk factors, and troponin interpretation to evaluate level of risk, and has consistently been shown to accurately predict very low incidence of any subsequent adverse events.