ACEP Chest Pain Policy: Emergency Physician Awareness

Abstract

Study objective: To assess emergency physician knowledge of and effect on clinical practice of the ACEP "Clinical Policy for Management of Adult Patients Presenting With a Chief Complaint of Chest Pain, With No History of Trauma." Methods: We conducted a written survey of attending physicians by mail and in person at emergency medicine meetings. Residents were surveyed at their academic departments. The survey recipients were emergency physicians and residents from university, community teaching, urban, and rural hospitals. Results: Of the 338 surveyed physicians, 163 (48%; 95% confidence interval [CI], 43% to 54%) said that they were aware of the policy. Fifty-four percent of ACEP members said they were aware of the policy, compared with 24% of nonmembers. Of the physicians who said they were aware of the policy, 63% did not know that the policy contains rules. Seventy-one percent of the physicians who were aware of the policy incorrectly believed the policy requires treatment with thrombolytic therapy in certain cases of myocardial infarction. Physicians said they learned about the policy by reading it (42%), by word of mouth (16%), or in department/quality-assurance meetings (13%). Twelve percent of physicians believe the policy has changed their clinical practice. Conclusion: Fewer than half the emergency physicians we surveyed were aware of the policy. Of the physicians who said they had been aware of the policy, most did not know important specifics of the policy. [Wigder HN, Arai DA, Narasimhan K, Cohan S: ACEP chest pain policy: Emergency physician awareness. Ann Emerg Med May 1996;27:606-609.] See related editorial, Emergency Medicine Clinical Guidelines: We Can Make Them, but Will We Use Them?