Development of a clinical pathway for acute coronary syndrome at Philippine General Hospital

Cecileen Anne M Tuazon; Paul Anthony O Alad; Albert Roy M Rollorazo; Lauren Kay Evangelista; Ruth Divine Agustin; Valerie Ramiro; John Christopher Pilapil; Bianca Velando; Mark Joseph M Abaca; Jerahmeel Aleson L Mapili; Diana R Tamondong-lachica; Eric Oliver D Sison; John C Añ; Onuevo; Felix Eduardo R Punzalan

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Development of a clinical pathway for acute coronary syndrome at Philippine General Hospital

Author: Cecileen Anne M. Tuazon ¹ ; Paul Anthony O. Alad ¹ ; Albert Roy M. Rollorazo ¹ ; Lauren Kay Evangelista ¹ ; Ruth Divine Agustin ¹ ; Valerie Ramiro ¹ ; John Christopher Pilapil ¹ ; Bianca Velando ¹ ; Mark Joseph M. Abaca ² ; Jerahmeel Aleson L. Mapili ² ; Diana R. Tamondong-Lachica ² ; Eric Oliver D. Sison ^{1
,

2} ; John C. Añonuevo ^{1
,

2} ; Felix Eduardo R. Punzalan ^{1
,

2}
Author Information

1. Division of Cardiovascular Medicine, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
2. Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
Publication Type:Journal Article
MeSH: Acute Coronary Syndrome; Critical Pathways; Quality of Health Care
From: Philippine Journal of Cardiology 2024;52(1):61-92
CountryPhilippines
Language:English
Abstract: BACKGROUND:Acute coronary syndrome (ACS) is a leading cause of admission and mortality in a tertiary care hospital in the Philippines. The significant burden of the disease necessitates that evidence-based care set by international and local guidelines be met to improve service delivery and quality of care (QOC). Institution-specific QOC studies showed gaps between guideline recommendations and compliance. Development and utilization of a clinical pathway are among the identified strategies to improve compliance. It is also crucial for implementation of standard-of-care set specific to a hospital setting based on its needs and resources.
METHODS:This is a descriptive research on the development of a clinical pathway for ACS appropriate for the emergency room setting of a tertiary care hospital from March 2021 to August 2022. Local QOC studies and evidence behind the latest international guideline recommendations on the management of ACS were reviewed to create the interim ACS Pathway. Two-level content validation of the interim pathway was done: internal validation with the consultants and fellows of the Division of Cardiovascular Medicine and external validation through focused group discussions with different hospital units and stakeholders to assess applicability and feasibility based on the resources of the setting, identify hindrances, and propose solutions in its implementation.
RESULTS:An evidence-based clinical pathway for ACS that encompasses identification and management of ST-segment elevation myocardial infarction and non–ST-segment elevation acute coronary syndrome with judicious use of locally available and feasible resources applicable for local emergency room hospital setting was created.
CONCLUSION:Review of local QOC studies and interdepartmental collaboration are necessary components in developing institution-specific clinical pathway for ACS.
Full text:202410091057079708761.pdf