Standardized Care Pathway Versus Conventional Approach in the Management of Patients Presenting with Faint at the University of Utah.

Background Despite the availability of guidelines, the evaluation of patients with faint continues to be inconsistent. The purpose of this study was to test the hypothesis that utilization of a new standardized-care pathway (Faint-Algorithm) reduces hospital admissions and improves diagnostic yield...

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Published in:Pacing & Clinical Electrophysiology Vol. 36; no. 2; pp. 152 - 163
Main Authors: Sanders, Natalie A., Jetter, Tawni L., Brignole, Michele, Hamdan, Mohamed H.
Format: algorithm research tables/charts Journal Article
Published: Wiley-Blackwell Feb2013
Online Access:View this record in EBSCOhost
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      dt: Feb2013
      vid: 36
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Standardized Care Pathway Versus Conventional Approach in the Management of Patients Presenting with Faint at the University of Utah.
      aug:
        au:
          Sanders, Natalie A.
          Jetter, Tawni L.
          Brignole, Michele
          Hamdan, Mohamed H.
        affil: Division of Geriatrics, University of Utah Medical Center
      sug:
        subj:
          Syncope Diagnosis
          Patient Admission
          Hospitalization Statistics and Numerical Data
          Critical Path Utilization
          Human
          Syncope Epidemiology
          Utah
          Descriptive Statistics
          Risk Assessment Methods
          Prevalence
          Retrospective Design
          T-Tests
          Fisher's Exact Test
          Logistic Regression
          Data Analysis Software
          Adult
          Middle Age
          Aged
          Male
          Female
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background Despite the availability of guidelines, the evaluation of patients with faint continues to be inconsistent. The purpose of this study was to test the hypothesis that utilization of a new standardized-care pathway (Faint-Algorithm) reduces hospital admissions and improves diagnostic yield when compared to the conventional approach in the evaluation of patients with faint. Methods We reviewed the data of 154 consecutive patients presenting with faint to the Faint and Fall Clinic at the University of Utah (standardized group) and 100 patients previously evaluated for faint using the conventional approach (conventional group). Results Using a standardized approach, only 4% of patients were admitted when compared to 20% in the conventional group (P < 0.001). The rate of diagnosis at initial evaluation was similar between the groups; however, at 45 days, it was greater in the standardized group when compared to the conventional group (57% vs 45% in the total population, P = 0.09; 57% vs 39% in the outpatient subgroups, P = 0.02). The number of tests or consultations associated with additional charges was significantly lower in the standardized group when compared to the conventional group (1.9 ± 1.0 vs 2.6 ± 1.2, P = 0.001). Conclusions The use of a standardized approach in the evaluation of patients with faint decreased the number of hospital admissions and increased the rate of diagnosis at 45 days. This was achieved with less utilization of costly tests and consultations.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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