Improving the Management of Acute Coronary Syndromes in the Emergency Department (RACE)
By using a Rapid Cardiac Evaluation (RACE) pathway in the Emergency Department (ED), the investigators can effectively reduce ED wait times and ED length of stay by decreasing overall hospital admissions and telemetry admissions. In addition, the investigators hypothesize a decrease in mortality of those patients admitted for cardiac evaluation by increasing the patient to health care provider ratio.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Single Blind (Subject)
Primary Purpose: Diagnostic
|Official Title:||Improving the Management of Acute Coronary Syndromes in the Emergency Department Using a Rapid Acute Cardiac Evaluation Pathway|
- ED length of stay [ Time Frame: Average of 3 hours stay in the Emergency Department ] [ Designated as safety issue: No ]From patient check-in time to patient admit or discharge time
- Mortality rate of admitted patients [ Time Frame: During hospital admission and at 30 days ] [ Designated as safety issue: Yes ]Average hospital stay 3 days.
- Hospital Admission Rate [ Time Frame: Baseline ] [ Designated as safety issue: No ]Observing the rate at which physicians admit patients to the hospital.
|Study Start Date:||June 2011|
|Study Completion Date:||December 2011|
|Primary Completion Date:||December 2011 (Final data collection date for primary outcome measure)|
No Intervention: Core Laboratory
Patients receiving serial routinely available cardiac biomarker testing in a core laboratory setting using Troponin T. (Roche Centaur)
Active Comparator: Point of Care
Patients will receive the Point of Care testing intervention using serial cardiac biomarker testing at the bedside including myoglobin, Troponin I and CK-MB. (Triage Cardiac Panel, Alere)
Device: Point of Care testing
The investigators will implement 6 months of randomized testing periods, 2 weeks each. During this 2 week block, cardiac biomarkers will be tested at the bedside in the ED using the Triage Cardiac Panel that will test for CK-MB, Myoglobin, and Troponin I.
Each blood sample that is take for point of care testing will be saved. The plasma from the saved sample will be frozen and the sample will be sent to an off-site testing center for high sensitivity troponin testing.
All patients will be followed at the 30-day mark and those patients who are discharged home from the ED will be followed within 48 hours as well.
Other Name: Triage Cardiac Panel by Alere
|United States, New York|
|New York Methodist Hospital|
|Brooklyn, New York, United States, 11215|
|Principal Investigator:||Bethany A Byrd, D.O.||New York Methodist Hospital|