NY Cardiology Critical Pathways

In 2004 a new program “Advanced Cardiac Admission Program” (ACAP) was developed and implemented at St. Luke’s-Roosevelt Hospital Center, New York, NY.

The program consists of a series of projects to develop and test tools and strategies for implementing guidelines. Because each project is focused on a particular guideline, the specifics of each project differ. Key features common to all projects include:

1. Building partnerships with emergency room physicians.

2. Flexibility to allow local adaptation

3. Tools derived directly from published guideline

4. Involvement of caregivers across the continuum of care (i.e., not just cardiologists)

5. Involvement of patients in their care.

6. Use of champions/opinion leaders (Attending, Specialists)

7. Use of data to change behavior and measure effectiveness of the approach.

ACAP Main Projects:

1. Chest Pain Pathway, (PAIN) including STEMI and NSTEMI patients.
2. Heart Failure Pathway. (for Acute management of Heart Failure)
3. The RACE Pathway for Atrial fibrillation & Flutter.
4. Pathway for management of Hyperglycemia in Critical & Cardiac Care Units.
5. The SELF Pathway for Syncope. (Launch date 9/06)
6. Pathway for management of Hypertension. (Launch date 10/06)

 Implementation of the ACAP program:

1. A focused treatment guideline, in a form of novel easy to understand pathways.
2. Printed color coded standardized admission and discharge orders.
3. Educational lectures and materials supplemented to all house staff.
4. An integrated database was developed to incorporate all collected in data.