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Providing a safe and efficient method of chest pain assessment

Associate Professor Jaimi Greenslade, Institution: Queensland University of Technology

2019 Partnership Engagement Grant

Years funded: 2021-2023


Over 450,000 patients present to Australian Emergency Departments (ED) every year with warning signs for heart attack. Emergency doctors assess such patients using guidelines published by the National Heart Foundation of Australia (NHFA) in 2016. These guidelines are accurate for identifying patients having a heart attack. However, over 85% of the patients presenting to the ED with chest pain are not having a heart attack. The assessment process for these patients takes considerable time, is costly, can expose patients to risks and places burden on a healthcare system that is already under considerable strain from overcrowding and a lack of resources. Overcrowding reduces patient safety and is associated with approximately 1,500 deaths in Australia per year a figure similar to the road toll. Strategies that streamline the assessment of chest pain patients in the ED are urgently required.

This project we will evaluate a new method for assessing chest pain with two aims. First, we seek to reduce the burden on the healthcare system safety. Cost savings are estimated $95 million per year if implemented Australia wide. Second, we aim to change the focus of assessment from a clinician led model to a patient-centred model by incorporating patient preferences. The incorporation of patient preferences is important as it improves patient outcomes.

The new pathway will be implemented across multiple hospitals. Data collected before and after the implementation of this pathway will be used to assess whether the strategy
  1. reduces length of stay,
  2. is safe for identifying heart attack,
  3. reduces healthcare utilisation and costs, and
  4. improves patient satisfaction.

The new chest pain pathway will that the patient needs and values are incorporated in clinical decision making. It will also reduce utilisation of healthcare resources.

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