Akuter Thoraxschmerz: Chest-Pain-Unit – die Zertifizierungskampagne der Deutschen Gesellschaft für Kardiologie

Abstract

The Chest Pain Unit (CPU) Task Force of the German Society of Cardiology inaugurated elaborated prerequisites for a CPU certification program to evaluate CPUs across the country. For this reason, a consensus document including criteria for CPUs was developed and published in October 2008. Aim of this effort is to ensure a network of elaborated centers which meet or exceed quality-of-care measures in order to improve the standard of care of patients with acute thoracic pain. After application and a formal checkup of the institution, the minimum requirements are assessed by an expert committee of the German Society of Cardiology according to presubmitted documentation of the care processes for patients with acute thoracic pain. Components of certification include characteristic locations, equipment, diagnostic and therapeutic strategies, cooperations, staff education, and organization. Certification specifically implies algorithms for ST segment elevation myocardial infarction, non-ST segment elevation myocardial infarction, unstable angina, stable angina, hypertensive crisis, acute pulmonary embolism, acute aortic syndrome, cardiogenic shock, and resuscitation. Availability of a catheter laboratory ready within the facility is mandatory. The CPU and the cath lab are obliged to be available 24 h per day over 365 days per year. After successful documentation review, a certification audit team reviews the facility's application, infrastructure, patient care, and each of the requirements according to the consensus document on site and makes recommendations to the expert committee. Certification is finally awarded by the expert committee of the German Society of Cardiology to those CPUs which fulfill the dedicated requirements and successfully run through the complete certification process. Within this process, CPUs can plan and organize the delivery of care in a systematic manner, and the differentiation between minimum requirements and best practice allows further developments and innovations.

The Use of Echocardiography in Certified Chest Pain Units: Results from the German Chest Pain Unit Registry

“…The individual pathways determine the choice of advanced assessment in terms of invasive or noninvasive diagnostics as described elsewhere [4,5,7]. Unfortunately, the term ‘unstable' is lacking a concrete definition.…”

“…According to the SCPC, CPUs in Germany are required to meet well-defined key element characteristics [4,5,6,7]. So far, only Germany and the USA provide such widely adopted national programs for professional society accreditation as a CPU [18].…”

“…In 2008, the first consensus document for Chest Pain Units (CPUs) in Germany was published by the German Cardiac Society (GCS) as the basis for national accreditation [4]. The GCS then started a nation-wide CPU network to certify those CPUs fulfilling or exceeding quality-of-care characteristics for the prompt identification and treatment of patients at risk [5,6,7]. …”

Criteria of the German Society of Cardiology for the establishment of chest pain units: update 2014

“…Based on the evaluation, the DGK issues either a certification (“CPU–DGK certified” logo), a rejection (with justification), or a certification pending fulfillment of conditions [ 42 ].…”

Kardiale Notfälle: neue Lösungen für alte Probleme

“…Auf dem Boden dieser Qualitätsemp-fehlungen können nun CPUs in Deutschland zertifiziert werden. Breuckmann et al beschreiben den Zertifizierungsprozess, der zum Ziel hat, flächende-ckend in Deutschland etwa 300-400 CPUs mit nachprüfbarer Qualität zu installieren [9].…”