Key result
As of September 2020, 5,228,973 patients were enrolled from 4,621 registered hospitals in China to evaluate chest pain center accreditation, with 34.6% having acute coronary syndromes.
Why the study?
The study was designed to evaluate the effectiveness and implementation of chest pain center accreditation in China and identify factors influencing its implementation in local settings.
Does chest pain center accreditation improve the quality of care for patients with acute chest pain?
Cohort (n=5,228,973)
Yes
Does chest pain center accreditation improve the quality of care for patients with acute chest pain?
The National Chest Pain Centers Program in China is a massive nationwide initiative aiming to standardize and improve care for acute chest pain, with over 5 million patients enrolled to date.
This nationwide ACS registry now supports quality surveillance; leaves open whether CPC accreditation improves processes or outcomes.
Background: The National Chest Pain Centers Program (NCPCP) is the largest nationwide, hospital-based, multifaceted, continuous quality improvement initiative, which aims to monitor and improve the quality of care for patients with acute chest pain. The accreditation of the standardized chest pain center is central to the project. The purpose of establishing chest pain centers is to develop a mechanism for “sending acute chest pain patients to a hospital with capabilities for the best treatment in the shortest time possible.” Objectives: This study aims to evaluate the effectiveness and implementation of the chest pain center accreditation and to identify factors that may influence its implementation in local settings. Study Design and Methods: Hospitals that have been accredited between January 2016 and September 2020 will be recruited in this study. We will conduct a self-controlled retrospective cohort study by comparing the care performance before, during, and after the accreditation. Measures for care performance will be selected based on the American College of Cardiology/American Heart Association clinical practice guidelines, which will be divided into prehospital processes, in-hospital processes, and in-hospital outcomes. For the implementation of the chest pain center accreditation, we will use a modified reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework to investigate the implementation process, and the consolidated framework for implementation research will be used to identify factors that emerge within the local context and influence the implementation fidelity and feasibility. Progress to Date: As of September 2020, there were 4,621 hospitals that registered the NCPCP, of which 1,507 hospitals were accredited. A total of 5,228,973 patients with a primary diagnosis on admission were enrolled from the registered hospitals, among which 34.6% were acute coronary syndromes. Conclusions: In this study, we proposed recommendations for improving the implementation of chest pain center accreditation, which will improve the quality of care for patients with acute chest pain and promote the sustainable development of chest pain center. Trial Registration: ClinicalTrials.gov, NCT04014972, registered July 10, 2019
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Xiang et al. (2021) conducted a cohort in Acute chest pain (n=5,228,973). Chest pain center accreditation vs. Before accreditation (self-controlled) was evaluated on Care performance (prehospital processes, in-hospital processes, and in-hospital outcomes). As of September 2020, 5,228,973 patients were enrolled from 4,621 registered hospitals in China to evaluate chest pain center accreditation, with 34.6% having acute coronary syndromes.
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