Research Activities #264, August 2002


emergency department (ED) miss a diagnosis of heart attack (acute myocardial infarction, AMI) or unstable angina, they put the patient at risk and open the door to a possible malpractice suit. Physician use of an electrocardiograph-based ED risk management tool, which predicts the probability of acute ischemia (AMI or unstable angina), substantially reduces malpractice costs, according to a study supported by the Agency for Healthcare Research and Quality (HS07360). A second AHRQsupported study (HS08212) shows that a suspected heart attack patient who is identified in the ED is more likely to receive potentially lifesaving thrombolytic (clot dissolving) therapy or angioplasty when another ECG-based predictive instrument indicates the benefits of thrombolytic therapy for the patient at the time of the ECG. Both studies, which were led by Harry P. Selker, M.D., M.S.P.H., of Tufts-New England Medical Center, are summarized here. Selker, H.P., Beshansky, J.R., Pozen, J.D., and others. (2002, winter). “An electrocardiographbased emergency department risk management tool based on the acute cardiac ischemia timeinsensitive predictive instrument (ACI-TIPI): Potential impact on care and on the occurrence and outcomes of malpractice claims.” Journal of Healthcare Risk Management pp. 11-18. An ED risk management form automatically generated by electrocardiographs that include an ECG-based acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) could reduce malpractice costs nationally by $1.2 billion a year, concludes this study. The ACI-TIPI generates a 0-100 percent probability that the ED patient has acute cardiac ischemia and may prompt doctors to consider and document key clinical factors for each ED patient with chest pain or related symptoms. It reduces the likelihood of malpractice suits because it helps ED doctors appreciate the importance of ECG abnormalities, the need to hospitalize certain Research Activities

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@inproceedings{Grady2002ResearchA, title={Research Activities #264, August 2002}, author={Mary L . Grady}, year={2002} }