• Kaat Siebens, Hielko Miljoen, Steffen Fieuws, Barbara Drew, Sabina De Geest, and Christiaan Vrints.
• Cardiology Department, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem, Belgium. kaat.siebens@uza.be
• Crit Pathw Cardiol. 2010 Mar 1;9(1):30-4.

ObjectiveTo compare length of stay (LOS), clinical and psychological outcomes, and patient satisfaction before and after implementation of a chest pain critical pathway.DesignA pre- and post-test quasi-experimental design.SettingThe Chest Pain Unit (CPU) of the Antwerp University Hospital.PatientsPatients admitted to the CPU with symptoms suggestive of an acute coronary syndrome older than 18 years.InterventionsImplementation of a critical pathway focusing on implementation of the guidelines for the management of chest pain.Main Outcome MeasuresPatient satisfaction, length of stay and anxiety were evaluated.ResultsThe median LOS of intervention subjects was almost 4 hours shorter than that of control subjects (without, P = 0.04, or with propensity correction, P = 0.019). The overall patient satisfaction with CPU care of the intervention group was significantly higher than that of the control group (without, P < 0.001, or with propensity correction, P < 0.001). Differences in anxiety and occurrences of major adverse cardiac events between the groups were not statistically significant.ConclusionA critical pathway can effectively and safely reduce LOS, increase patient satisfaction, and improve adherence to the guidelines for managing patients with chest pain. Anxiety is not statistically significantly reduced by this intervention.

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