Critical Pathways in Cardiology
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Lippincott Williams & Wilkins | ISBN 0781726212 | 2001 Year | PDB | 2,37 Mb | 260 Pages
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Harvard Medical School, Boston, MA. Using an evidence-based approach, this resource explains the how and why behind critical pathways, with special emphasis on their practical application in cardiology. Numerous tables, checklists, and algorithms are included.
The past 10 to 15 years have witnessed remarkable progress in the field of cardiology. The evidence that has emerged on effective new therapies for several important cardiovascular diseases is quite impressive. For example, the treatment of acute myocardial infarction 15 years ago consisted of nitroglycerin, beta-blockers, and morphine. Now patients also receive fibrinolytic therapy, aspirin, heparin, ACE inhibitors, statins, and, in some cases, glycoprotein IIb/IIIa inhibitors. Indeed, we are in an era when each year there are new therapies and approaches to the management of patients with every cardiac condition.
How do busy clinicians keep up with the latest advances and ensure that their patients receive current state-of-the-art therapy? One approach has been the development and use of critical pathways. These are standardized documents or computer order sets that incorporate new therapies and simultaneously attempt to streamline treatment in order to make it more cost-effective. Critical pathways have grown in use, initially as a means of reducing hospital length of stay. However, they offer a unique opportunity to raise the standard of care at institutions, while at the same time to include all the appropriate tests and treatments for patients. In this fashion, they serve as a readily available guide to the clinician when treating the patient. They also may serve as a means of improving compliance with current guidelines for treating patients.
We are delighted to present in this book a full array of critical pathways from leading institutions around the country. These pathways are the “best practices” for these hospitals, developed by leaders in their areas of expertise. The authors have done a superb job of integrating the key clinical data into brief summaries and then providing the critical pathways that they use at their hospitals. We have organized this book in a fashion to facilitate using the information. We begin with an overview of what critical pathways are and how to develop them. We then present several pathways for management of patients in the Emergency Department, focusing on patients with acute coronary syndromes. The next section covers the types of patients who are admitted to the hospital, and the final section includes several outpatient critical pathways, such as management of hypertension and lipid disorders. It is hoped that these pathways will allow clinicians around the world to adopt critical pathways more easily as a means of improving the care of their cardiac patients.