2022 Quality Summit ePosters (Non-CE) - Cardiac Cath Lab Accreditation-1. Stepped Wedge Non-randomized Implementation of the Canadian Syncope Pathway: A Pilot Study

1. Stepped Wedge Non-randomized Implementation of the Canadian Syncope Pathway: A Pilot Study

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The document summarizes a pilot study on the implementation of the Canadian Syncope Pathway, a tool developed to assess and manage patients who present to the emergency department (ED) with syncope (fainting). Syncope accounts for a significant number of ED visits and can have serious underlying causes. The objective of the study was to assess the feasibility of implementing the Canadian Syncope Pathway and evaluate process measures such as engagement, reach, adoption, and fidelity.<br /><br />The study was conducted at two cluster hospitals in Canada using a non-randomized stepped wedge design. Over a 5-month period, the intervention was implemented for three months in cluster 1 and two months in cluster 2. The study enrolled 1,008 patients, with 355 in the control period and 653 in the intervention period. The Canadian Syncope Risk Score (CSRS) was used to classify patients as low, medium, or high risk for serious outcomes. The intervention included the integration of the CSRS pathway into the electronic health records and various knowledge translation strategies.<br /><br />The study found that physician engagement varied but reached up to 97.1% for presentation at meetings. Hospitalization rates during the intervention period were slightly lower than during the control period. Feasibility benchmarks for recruitment, adoption, reach, and fidelity were successfully achieved.<br /><br />The authors concluded that a widespread implementation of the Canadian Syncope Pathway would lead to a more standardized approach to ED syncope, reduce healthcare costs, and improve efficiency and patient safety. The study achieved the necessary feasibility benchmarks for proceeding to a multicentre implementation of the pathway.<br /><br />In summary, the pilot study demonstrated the feasibility of implementing the Canadian Syncope Pathway in two cluster hospitals and showed promising results in terms of engagement, adoption, and process measures. The pathway has the potential to improve the management of syncope in the ED and reduce healthcare costs.

Keywords

Canadian Syncope Pathway

syncope

emergency department

feasibility

process measures

implementation

cluster hospitals

Canadian Syncope Risk Score

physician engagement

hospitalization rates