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An audit of acute coronary syndrome assessment (TIMI scoring) and treatment

Stephanie Coughlin (Bedford Hospital NHS Trust, Bedford, UK)
Frank Milligan (Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK)

Clinical Governance: An International Journal

ISSN: 1477-7274

Article publication date: 25 April 2008




The purpose of this paper is to report the findings of an audit undertaken on the use of the Thrombolysis in Myocardial Infarction (TIMI) scoring system, and adherence to agreed treatment protocols, in the triage of patients with cardiac chest pain.


A retrospective review of case notes. Sixty eight patients were audited on the use of TIMI score and 64 of these were further audited on the management commenced in the emergency department.


Only nine of the 68 patients with cardiac chest pain had a TIMI score documented. Of the 64 patients, 31 analysed for treatment commenced were managed correctly, 33 patients (n=64) were either under or over treated.

Practical implications

Adherence to clinical guidelines should be subject to audit review to assess impact on patient outcomes. Over‐treatment included administration of unnecessary anticoagulants raising patient safety and cost issues. Under‐treatment left patients vulnerable to further cardiac events.


This paper demonstrates the value of utilising audit data in quantifying adherence to clinical guidelines, thereby improving patient outcomes.



Coughlin, S. and Milligan, F. (2008), "An audit of acute coronary syndrome assessment (TIMI scoring) and treatment", Clinical Governance: An International Journal, Vol. 13 No. 2, pp. 138-141.



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

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