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  QM1 - Monitoring of Troponin Metrics for Chest Pain Centers

 

Posted January 16, 2012

Patients presenting to the emergency department (ED) with chest pain must be evaluated quickly. Rapid serum troponin measurement is an important part of ED practice that can provide decisive information for patient management. Reducing delays in troponin testing has been reported to result in shorter length of stay in the ED and more rapid initiation of antiischemic treatment. Chest pain centers should therefore have effective procedures for ensuring optimal turnaround time (TAT) for troponin and a process for ongoing monitoring to ensure that performance meets expectations. Participants will monitor two to eight metrics required by the Society of Chest Pain Centers (Cycle IV: Key Element 4.4.0.0) and monitor the CMS requirement (Measure OP-16) for troponin turnaround time of 60 minutes or less when measured from patient arrival to result availability.

Objective

Help meet the CMS and Society of Chest Pain Centers (SCPC) quality performance requirements for monitoring ED troponin TAT and meeting timeliness goals.

Data Collection

Select a sample of patients in whom troponin is measured and record time points for certain actions in the testing process. These times include patient arrival, test order, specimen collection, laboratory receipt, and result availability. Participants will select which metrics to monitor, with the option to monitor all metrics. Participants will also complete a questionnaire about clinical and laboratory practices related to troponin testing.

SCPC Metrics

Main Laboratory Troponin Testing
at least one of the following:

  • Patient arrival to result availability
  • Specimen collection to result availability
  • Test order to result availability and at least one of the following:
  • Patient arrival to test order
  • Test order to specimen collection
  • Specimen collection to laboratory receipt
  • Laboratory receipt to result availability

Point-of-Care Troponin Testing

  • Specimen collection to result availability (required)
  • Patient arrival to result availability (optional)

Performance indicators

  • Median TAT for troponin testing intervals (monthly)
  • Test order to result availability compliance rate (if applicable)
  • Specimen collection to result availability compliance rate (if applicable)

Reports

Participants will receive benchmarking, as compared to all institutions, for specimen collection to result availability turnaround time. A report will be provided on a quarterly basis for compliance with Chest Pain Center key element 4.4.0.0; ED Baseline Troponin Turn-Around-Time Metrics.

 

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