Chest Pain Center Accreditation

CPC v5 is an operational model merging the latest scientific evidence with process improvement initiatives for the care of the patient suspected of having a myocardial infarction.

CPC v5 combines evidence-based science, quality initiatives, ACC/AHA guidelines and clinical best-practices to produce the most effective care delivery model for LOW-RISK, NSTE-ACS, STEMI and Resuscitation. The focus of CPC v5 is to optimize resource utilization and to improve patient outcomes. CPC v5 was engineered by a team of over 50 nationally recognized healthcare leaders with specialties in emergency and observation medicine, interventional cardiology, hospitalist, executive administration, social work, nursing, information technology, and governmental policies.

Data Requirement Update About NCDR ACTION Registry® and CPC v5 Integration

Duplicate data entry of STEMI/NSTEMI patients is not required for those facilities that actively participate in NCDR ACTION Registry® to satisfy ACD data requirements for CPC v5 Accreditation. Current customers may review the related release note in the CPC v5 tool.

Chest Pain Center Accreditation Designations

There are three types of designations for Chest Pain Center v5 Accreditation which are based on the facility's STEMI treatment strategies:

  • Chest Pain Center
  • Chest Pain Center with Primary PCI
  • Chest Pain Center with Primary PCI & Resuscitation

Designation Requirements

Chest Pain Center: This designation is for those facilities that do not have 24/7 primary PCI coverage every day of the year. Facilities with this designation will have a robust detailed transfer (referral) protocol in place which addresses transfer procedures and/or potential fibrinolytic therapy if the expected first medical contact to intervention time will exceed 120 minutes. Their plans will also include written agreements with:

  • EMS ground transport agencies
  • Air transport agencies
  • Receiving Centers where they send patients for Primary PCI

They empower their Emergency Department physicians with the authority to initiate the reperfusion strategy used based on current environmental conditions and available resources. In a timely manner this group freely shares follow-up and aggregate data with all institutions involved in the care of their STEMI patient.

Chest Pain Center with Primary PCI: Hospitals awarded this designation have Primary PCI available 24/7 every day of the year. This means they have a call team made up of the cardiac cath lab staff and an interventional cardiologist who arrive to the facility within 30 minutes of STEMI activation. These facilities have formal agreements with the facilities that regularly refer STEMI patients for primary PCI. They will also have mapped their STEMI processes to maximize efficiencies which lead to quicker treatment and improved outcomes. This includes:

  • The ED physician having the authority to activate the cath lab
  • A One-Call Activation System
  • No STEMI Diversion Policy
  • Formalized back-up protocol for simultaneous STEMI Activations or when the lab is "down"
  • Defined roles and responsibilities for all STEMI team members

Chest Pain Center with Primary PCI and Resuscitation: It is estimated that over 60% of all cardiac arrests are directly caused from an acute myocardial infarction. The addition of the Resuscitation designation to Chest Pain Center with PCI accreditation enhances outcomes because the facility will have initiated early strategies such as early recognition, CPR and defibrillation, early intervention with Primary PCI simultaneously with post arrest hypothermia treatment. All mandatory items for the Primary PCI Designation must be met to be eligible to apply for the additional Resuscitation designation. Patients who have return of spontaneous circulation (ROSC) after cardiac arrest may have had a STEMI. Positive outcomes and ability to ambulate out of the facility exponentially improve with hypothermia therapy and early invasive strategy such as Primary PCI. Therefore, Chest Pain Center with Primary PCI and Resuscitation designated facilities are equipped with a robust hypothermia program which includes policies, procedures, and protocols for post arrest treatment. These facilities must also maintain a "No Diversion Policy" for out of hospital cardiac arrest patients. This designation also requires a separate Multidisciplinary Resuscitation Committee which has representation from:

  • EMS
  • Nursing
  • Medical (Cardiologist, Neurologist, Emergency, Critical Care)
  • Administration

Features & Benefits of Chest Pain Center Accreditation

CPC v5 Accreditation Delivers Results: Lower Costs, Improves Patient Outcomes And Patient Satisfaction

  • Streamline processes for the diagnosis, treatment, and management of patients in the appropriate location
  • Reduce costly admissions and ensure appropriate length-of-stay (LOS)
  • Improve patient engagement leading to improved satisfaction scores
  • Evidence-based medicine aligned with process improvement
  • Each Item is aligned with the latest ACC/AHA Guidelines

CPC v5 Provides Actionable Data To Support Clinical Decisions

  • Access on-demand to calculated measures for the care of LOW-RISK, NSTE-ACS, STEMI and Resuscitation
  • Track key performance metrics on the quality of care and identify opportunities for improvement
  • Associate operational measures to patient outcomes and organizational performance

CPC v5 Essential Components Organize Process Improvement Efforts

Governance – Administrative support to align resources with appropriate services
Community Outreach – Community education programs through partnerships with health care providers, employers, and the community at large to increase public awareness of the value for early patient engagement for heart attack care and hands only CPR.
Pre-Hospital Care – Partner programs with EMS to integrate first point of care processes with pre-hospital systems.
Early Stabilization – Immediate stabilization and routing using processes to evaluate, stratify, and treat patients at risk of having an occlusive event.
Acute Care – A multidisciplinary, patient-centric approach from initial system entry to discharge, with continuous evaluation of appropriate care in the appropriate location, whether observation status or in-patient admission, to ensure an appropriate LOS
Transitional Care – Establish care coordination at discharge, including early follow-up care and patient/family education, to prevent unnecessary and costly re-admissions.
Clinical Quality Measures – Measure and evaluate operational performance and adherence to evidence-based guidelines, proven to optimize the quality of care.

CPC v5 Once Your Hospital Goes Through CPC v5 Accreditation, Your Facility Will Start To Notice These Benefits:

  • Operational efficiencies leading to improved patient throughput and volumes
  • Better performance of Centers for Medicare & Medicaid Services (CMS) core measures for the Acute Coronary Syndrome (ACS) patient
  • More timely and accurate diagnosis and treatment
  • Better risk stratification which ensures appropriate placement of patients based on clinical presentation and initial response to treatment
  • Reduces the liability of missed heart attacks through a consistent approach to risk stratification of the ACS patient
  • Increased community awareness of ACS symptoms
  • Improved relationships with EMS and integration of EMS into patient care process
  • Reduced Door-to-Balloon (D-2-B) times
  • Decreased length-of-stay (LOS)
  • Bottom line improvement

Getting Started