Critical pathways as a strategy for improving care: problems and potential

Article Abstract:

The use of critical pathway guidelines has recently been introduced to the health care field, but their applicability to the field may need to be carefully researched. Critical pathway processes are a tool of quality improvement, and have been used in the business world as a way to identify and improve steps that slow down production. Critical pathways may be used to improve medical care by evaluating how things are currently done and looking for any variations as found in the medical literature or other institutions. Physicians should join teams of hospital staff assigned to formulate critical pathways to ensure that their views are considered. The effect of critical pathways on costs and outpatient resources needs to be evaluated.

Usage, Medical care, Quality management, Medical care quality, Critical path analysis

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Effective reperfusion for acute myocardial infarction begins with effective health policy

Article Abstract:

A targeted approach can reduce delay in seeking hospital care after a heart attack. Delay is important because clot-dissolving medication only helps when given shortly after symptom onset. Education campaigns might achieve greater success if they focus on persons at high risk for heart attack and the populations most likely to delay seeking care, who are women, the elderly, those with a history of congestive heart failure, and those whose symptoms begin in the afternoon or night. Another factor is surely health insurance coverage, a problem that must be addressed by improving health care delivery systems.

Care and treatment, Editorial, Management, Medical emergencies

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Emergency Department Triage Strategies for Acute Chest Pain Using Creatine Kinase--MB and Troponin I Assays: A Cost-Effectiveness Analysis

Article Abstract:

Measurement of creatine kinase-MB (CK-MB) levels in blood samples and exercise testing is a cost-effective way of diagnosing heart attack in young patients and people with a low risk of a heart attack. CK-MB is an enzyme that is released into the bloodstream when heart muscle is damaged. Older patients and those at high risk of a heart attack should be tested for elevated blood levels of troponin if their CK-MB level is normal and they cannot participate in exercise testing.

Methods, Diagnosis, Creatine kinase, Triage (Medicine)

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