Clinical guidelines on the management of Acute Coronary Syndrome (ACS) have
consistently shown a major gap between the guidelines and their application in
the actual management of ACS. In an attempt to achieve the goal of bridging the
gap between these evidence-based guidelines and patient management, we have
reorganized the pathway for the management of ACS at our institution. The
pathway has been designated with the acronym of PAIN (Priority risk, Advanced
risk, Intermediate risk, and Negative/Low risk), to reflect patients risk
stratification upon admission. Along with the pathway comes a single detailed
order sheet and a single discharge form which are color-coded according to the
patient's risk stratification.
This model is designed to mandate and, thus, markedly improve adherence to the
published American Heart Association/American College of Cardiology guidelines
for the management of ACS.