Case Study: Kaiser Permanente’s Emergency Department Management of Low-Risk Heart Disease Patients

Heart disease is the leading cause of death in the United States, and Emergency Departments are often filled with patients complaining of chest pain and related symptoms. Physician leaders at the Southern California Permanente Medical Group (SCPMG) attempted to address how to help avoid unnecessary hospitalization and testing, aid clinical decision making for physicians, and improve care for low-risk patients.

Adam Sharp, MD, and Ben Broder, MD, PhD, co-authored a case study published this week in NEJM Catalyst. The case study described the process taken in Kaiser Permanente Southern California to standardize the HEART score algorithm to assess patients with possible acute coronary syndrome (ACS). HEART, developed in The Netherlands, stands for History, ECG, Age, Risk Factors, and Troponin.

Dr. Sharp is a research scientist and emergency medicine physician at SCPMG and Dr. Broder is SCPMG’s assistant medical director of Quality and Clinical Analysis. The article was also co-written with Benjamin Sun, MD, principal investigator with the Center for Policy and Research in Emergency Medicine at Oregon Health and Science University.

In Kaiser Permanente Southern California, using the HEART score has helped emergency physicians work efficiently and reduce the rate of missed diagnosis well below the national average. The case study detailed steps the organization took to implement the HEART score and opportunities to spread the use of HEART or similar risk-stratifying tools moving forward.

Read the complete article on the NEJM Catalyst site.