Quality benchmarks for chest pain units and stroke units in Germany.
BACKGROUND
Chest pain units (CPUs) and stroke units (SUs) provide specialized multidisciplinary in-hospital management for acute chest pain and ischemic stroke. We analyzed exemplary equivalent quality benchmarks in both concepts.


MATERIAL AND METHODS
Data from the German CPU registry (2012-2015; 45 certified CPUs, 5881 patients) were compared with data from the SU registry of Rhineland-Palatinate (2011-2015; 29 SUs; 40,380 patients). Parameters comprised demographics, symptoms, diagnosis, medication, critical time intervals, therapeutics, and in-unit outcome.


RESULTS
Non-ST-segment elevation myocardial infarction (47.4%) and ischemic stroke (63.0%) were the most frequent entities. An electrocardiogram was performed on average within 7 min in CPUs, cranial imaging within 49 min in SUs. The mean time interval from admission until coronary intervention or lysis was 42 min or 57 min, respectively. Rates of antiplatelet therapy (90.1% vs. 96.0%), brain imaging, and coronary angiography were high (99.3% vs. 81.1%) and the mortality was low (0.8% for CPUs vs. 3.6% for SUs). The length of stay was shorter in CPUs (1.5 days vs. 4.4 days).


CONCLUSION
As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged.
['Breuckmann|Frank|F|', 'Hochadel|Matthias|M|', 'Grau|Armin J|AJ|', 'Giannitsis|Evangelos|E|', 'Münzel|Thomas|T|', 'Senges|Jochen|J|']
D019985:Benchmarking D002637:Chest Pain D005858:Germany D006801:Humans D000072658:Non-ST Elevated Myocardial Infarction D020521:Stroke
Coronary angiography Emergency medicine Acute coronary syndrome Brain ischemia Non-ST elevated myocardial infarction