SHM Converge Scientific Abstract ePoster Gallery-A Novel Emergency Department Syncope Protocol Reduced Unnecessary Admissions

Pdf Summary

A multidisciplinary team at the University of North Carolina developed and implemented a new emergency department (ED) syncope protocol to reduce unnecessary admissions and testing. The protocol used evidence-based criteria to guide decisions about diagnostic studies, hospital admission, and discharge, and it was reinforced through staff education, electronic medical record templates, and provider feedback. Patients deemed safe for discharge were given expedited follow-up in a syncope specialty clinic.<br /><br />The study compared ED syncope patients before protocol implementation (308 patients, September–December 2019) and after implementation (321 patients, January–June 2020). After the protocol was introduced, hospital admission rates fell significantly from 44.6% to 30.0%. However, use of diagnostic testing, including head CT, carotid ultrasound, and echocardiography, did not change significantly, nor did 30-day ED revisit rates. Referrals to the syncope specialty clinic increased from 1.5% to 8.8%.<br /><br />Importantly, patients referred to the syncope specialty clinic after protocol implementation had fewer 30-day ED revisits than those who were not referred. Overall, the findings suggest that a structured ED syncope care pathway can safely reduce admissions without increasing short-term return visits. The authors conclude that broader use of similar protocols may help reduce unnecessary healthcare utilization, though further studies are needed to assess cost and scalability.

Asset Subtitle

Michael Craig

Meta Tag

Author List Anil K. Gehi, Brian Wood, Meredith Williamson, Michael Craig

Category Research

Concept Syncope Care Protocol

Concept Syncope Decision Aid

Concept Hospital Admission

Concept 30-Day ED Revisits

Concept Admission Criteria

Distinguished Non-Finalist

Presenter Organization UNC School of Medicine

Presenting Author Michael Craig

Track Quality Improvement

Keywords

syncope protocol

emergency department

hospital admissions

diagnostic testing

evidence-based criteria

discharge decisions

electronic medical record

staff education

syncope specialty clinic

30-day ED revisits

Syncope Care Protocol

Syncope Decision Aid

Hospital Admission

30-Day ED Revisits

Admission Criteria