title: First Update of the Criteria for Certification of Chest Pain Units in Germany: Facelift or New Model?
abstract: OBJECTIVE
  In an effort to provide a systematic and specific standard-of-care for patients with acute chest pain, the German Cardiac Society introduced criteria for certification of specialized chest pain units (CPUs) in 2008, which have been replaced by a recent update published in 2015.
  
  
  METHODS
  We reviewed the development of CPU establishment in Germany during the past 7 years and compared and commented the current update of the certification criteria.
  
  
  RESULTS
  As of October 2015, 228 CPUs in Germany have been successfully certified by the German Cardiac Society; 300 CPUs are needed for full coverage closing gaps in rural regions. Current changes of the criteria mainly affect guideline-adherent adaptions of diagnostic work-ups, therapeutic strategies, risk stratification, in-hospital timing and education, and quality measures, whereas the overall structure remained unchanged. Benchmarking by participation within the German CPU registry is encouraged.
  
  
  CONCLUSIONS
  Even though the history is short, the concept of certified CPUs in Germany is accepted and successful underlined by its recent implementation in national and international guidelines. First registry data demonstrated a high standard of quality-of-care. The current update provides rational adaptions to new guidelines and developments without raising the level for successful certifications. A periodic release of fast-track updates with shorter time frames and an increase of minimum requirements should be considered.
authors.affiliation: From the *Department of Cardiology, Arnsberg Medical Center, Arnsberg, Germany; and †West German Heart and Vascular Center Essen, Department of Cardiology, University Duisburg-Essen, Essen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Breuckmann
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
mesh_terms: D019985:Benchmarking; D002568:Certification / Q000592:standards*; D002637:Chest Pain; D005858:Germany; D006757:Hospital Units / Q000592:standards*; D006801:Humans; D012042:Registries