Establishment of a Rapid Access Chest Pain Clinic at the Royal Hobart Hospital

Elford, A.; Black, Andrew; Flood, Joanne M.

doi:10.1016/j.hlc.2015.06.081

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The algorithm of RACPCs under NICE 95 Guidelines is as follows: Very low-risk patients are reassured and discharged; low-risk patients are offered cardiac computed tomography (CT); intermediate-risk patients are offered functional imaging; and high-risk patients are offered invasive coronary angiography or functional testing. [15][16][17] With over160 clinics rolled out in the UK and adoption in Australia, 18,19 reviews on RACPCs have been mixed. The system uses evidencebased medicine to shorten diagnosis times 20 and provides patients with faster reassurance, 21 but in some studies, it has increased investigation costs and hence, overall costs.…”

Section: Discussionmentioning

confidence: 99%

“…It yielded results comparable to the original Duke Clinical Score. 12,13 Patients were stratified into 3 risk cohorts according to the MCDS score: low (<10), intermediate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and high (>20); and compared between triages and controls. A sensitivity analysis was performed using the CAD Consortium Risk Score 14 (CRS)-a published European cardiovascular risk score not validated locally-…”

Section: Assessing Patients' Risk Scorementioning

confidence: 99%

See 1 more Smart Citation

Triaging Primary Care Patients Referred for Chest Pain to Specialist Cardiology Centres: Efficacy of an Optimised Protocol

Tan

Yap

Allen

et al. 2018

Ann Acad Med Singap

View full text Add to dashboard Cite

Introduction: Patients referred for chest pain from primary care have increased, along with demand for outpatient cardiology consultations. We evaluated ‘Triage Protocol’ that implements standardised diagnostic testing prior to patients' first cardiology consultation. Materials and Methods: Under the ‘Triage Protocol’, patients referred for chest pain were pretriaged using a standardised algorithm and subsequently referred for relevant functional diagnostic cardiology tests before their initial cardiology consultation. At the initial cardiology consultation scheduled by the primary care provider, test results were reviewed. A total of 522 triage patients (mean age 55 ± 13, male 53%) were frequency-matched by age, gender and risk cohort to 289 control patients (mean age: 56 ± 11, male: 52%). Pretest risk of coronary artery disease was defined according to a Modified Duke Clinical Score (MDCS) as low (<10), intermediate (10-20) and high (>20). The primary outcome was time from referral to diagnosis (days). Secondary outcomes were total visits, discharge rate at first consultation, patient cost and adverse cardiac outcomes. Results: The ‘Triage Protocol’ resulted in shorter times from referral to diagnosis (46 vs 131 days; P <0.0001) and fewer total visits (2.4 vs 3.0; P <0.0001). However, triage patients in low-risk groups experienced higher costs due to increased testing (S$421 vs S$357, P = 0.003). Adverse cardiac event rates under the ‘Triage Protocol’ indicated no compromise to patient safety (triage vs control: 0.57% vs 0.35%; P = 1.000). Conclusion: By implementing diagnostic cardiac testing prior to patients' first specialist consultation, the ‘Triage Protocol’ expedited diagnosis and reduced subsequent visits across all risk groups in ambulatory chest pain patients. Key words: Algorithm, Cardiac pain, Triage

show abstract