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...
| Published in: | Pacing & Clinical Electrophysiology Vol. 36; no. 2; pp. 152 - 163 |
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| Main Authors: | , , , |
| Format: | algorithm research tables/charts Journal Article |
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Wiley-Blackwell
Feb2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104068162&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104068162 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Feb2013 vid: 36 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104068162 85293301 10.1111/pace.12033 NLM23106288 104068162 ppf: 152 ppct: 11 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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