Objectives
To compare the outcomes and safety of a rapid access chest pain clinic (RACPC) in Australia with those of a general cardiology clinic.
Design
Prospective comparison of the outcomes for patients attending an RACPC and those of historical controls.
Setting
Royal Hobart Hospital cardiology outpatient department.
Participants
1914 patients referred for outpatient evaluation of new onset chest pain (1479 patients seen in the RACPC, 435 patients previously seen in the general cardiology clinic).
Main outcome measures
Service outcomes (review times, number of clinic reviews); adverse events (unplanned emergency department re‐attendances at 30 days and 12 months; major adverse cardiovascular events at 12 months, including unplanned revascularisation, acute coronary syndrome, stroke, cardiac death).
Results
Median time to review was shorter for RACPC than for usual care patients (12 days [IQR, 8–15 days] v 45 days [IQR, 27–89 days]). All patients seen in the RACPC received a diagnosis at the first clinic visit, but only 139 patients in the usual care group (32.0%). There were fewer unplanned emergency department re‐attendances for patients in the RACPC group at 30 days (1.6% v 4.4%) and 12 months (5.7% v 12.9%) than in the control group. Major adverse cardiovascular events were less frequent among patients evaluated in the RACPC (0.2% v 1.4%).
Conclusions
Patients were evaluated more efficiently in the RACPC than in a traditional cardiology clinic, and their subsequent rates of emergency department re‐attendances and adverse cardiovascular events were lower.
Introduction:We evaluated time efficiency and patient satisfaction of a "car park clinic" (CPC) compared to traditional face-to-face (F2F) during the COVID-19 pandemic.Methods: Consecutive patients attending CPC between September 2020 and November 2021 were surveyed. CPC time was recorded by staff. F2F time was reported by patients and administrative data.Results: A total of 591 patients attended the CPC. A total of 176 responses were collected for F2F clinic. Regarding satisfaction, 90% of CPC patients responded "happy" or "very happy." 96% reported feeling "safe" or "very safe." Patients spent significantly less time in CPC compared to F2F (17 ± 8 vs. 50 ± 24 min, p < .001).
Conclusion:CPC had excellent patient satisfaction and superior time efficiency compared to F2F.
In October of 2018, the Gold Coast University Hospital (GCUH) swapped from using a troponin I test (reference level ,0.4) to using a high sensitivity troponin I test (reference level ,10 in females and ,20 males) for evaluation of suspected cardiac chest pain. To determine the impact of the introduction of the high sensitivity troponin test, an audit was conducted. Coronary angiograms performed at the GCUH to investigate a troponin elevation over a 12-month period (6 months prior to and post the adoption of HscTnI) were recorded and analysed. Coronary Angiograms performed for ST elevation myocardial infarction were excluded. An angiogram was considered positive for severe coronary artery disease (CAD) if a 70% or greater stenosis in 1 or more epicardial vessels was found or operator opinion that percutaneous intervention or surgical intervention was warranted. Results: 338 coronary angiograms were performed in the 6 months prior to the adoption of HscTnI. Of these cases, 263 angiograms were positive for severe CAD. 351 coronary angiograms were performed in the 6 months since the adoption of HScTnI. Of these cases, 232 angiograms were positive for severe CAD. Conclusion: The use of the high sensitive troponin test resulted in an increase in the number of coronary angiograms performed with a decreased proportion of angiograms positive for severe CAD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.