Resource Utilization Reduction for Evaluation of Chest Pain in Pediatrics Using a Novel Standardized Clinical Assessment and Management Plan (SCAMP)

• Published in: Journal of the American Heart Association 2012-04, Vol.1 (2), p.n/a
• Main Authors: Verghese, George R., Friedman, Kevin G., Rathod, Rahul H., Meiri, Amir, Saleeb, Susan F., Graham, Dionne A., Geggel, Robert L., Fulton, David R.
• Format: Article
• Language: English
• Subjects: chest pain; Original Research; pediatrics; quality improvement; resource utilization
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.111.000349

Background Chest pain is a common reason for referral to pediatric cardiologists. Although pediatric chest pain is rarely attributable to serious cardiac pathology, extensive and costly evaluation is often performed. We have implemented a standardized approach to pediatric chest pain in our pediatric cardiology clinics as part of a broader quality improvement initiative termed Standardized Clinical Assessment and Management Plans (SCAMPs). In this study, we evaluate the impact of a SCAMP for chest pain on practice variation and resource utilization. Methods and Results We compared demographic variables, clinical characteristics, and cardiac testing in a historical cohort (n=406) of patients presenting to our outpatient division for initial evaluation of chest pain in the most recent pre‐SCAMP calendar year (2009) to patients enrolled in the chest pain SCAMP (n=364). Demographic variables including age at presentation, sex, and clinical characteristics were similar between groups. Adherence to the SCAMP algorithm for echocardiography was 84%. Practice variation decreased significantly after implementation of the SCAMP (P