title: Effectiveness and outcomes of a nurse practitioner-run chest pain evaluation unit.
abstract: BACKGROUND
  Every year, more than 5 million patients seek medical care for chest pain.
  
  
  OBJECTIVE
  The goal of this study was to evaluate test utilization and outcomes of a nurse practitioner (NP)-based chest pain unit and compare results to data previously reported from our institution.
  
  
  METHODS
  The records from 814 consecutive patients with chest pain admitted to the NP-run unit were compared to the outcomes of 250 patients admitted to a separate hospitalist-run unit at a New York City hospital.
  
  
  RESULTS
  Forty-four percent of patients in the NP unit underwent stress myocardial perfusion imaging (MPI) as the primary diagnostic test (compared to 22% in the hospitalist unit, p < .0001). The average length of stay was shorter for patients in the NP unit (2.7 ± 3.6 days compared to 3.9 ± 3.4 days, p < .0001). Additionally, the 90-day readmission rate was less for patients in the NP unit (2.7% vs. 3.9%, p < .0006).
  
  
  CONCLUSIONS
  An NP-run chest pain unit resulted in decreased length of stay and reduced readmission rates compared to a hospitalist-based unit.
authors.affiliation: Thomas Killip Division of Cardiology, Department of Medicine, Mount Sinai Beth Israel Medical Center, New York.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Thomas Killip Division of Cardiology, Department of Medicine, Mount Sinai Beth Israel Medical Center, New York.
authors.forename: Sirajul
authors.initials: S
authors.lastname: Islam
authors.affiliation: Thomas Killip Division of Cardiology, Department of Medicine, Mount Sinai Beth Israel Medical Center, New York.|Department of Medicine, The Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut.|Department of Diagnostic Imaging and Therapeutics, University of Connecticut School of Medicine, Farmington, Connecticut.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Bergmann
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D059408:Pain Management / Q000379:methods*; D010359:Patient Readmission / Q000706:statistics & numerical data; D057184:Practice Patterns, Nurses' / Q000592:standards* / Q000706:statistics & numerical data; D015397:Program Evaluation; D012189:Retrospective Studies
keywords: Nurse practitioner; chest pain; myocardial perfusion imaging; outcomes; telemetry