Complete
This was an innovation project supported by the Better Care Victoria Innovation Fund.
Lead organisation
SCV Emergency Care Clinical Network (ECCN)
Partners
18 emergency departments:
- Albury Base Hospital
- Angliss Hospital
- Austin Hospital
- Bairnsdale Hospital
- Bass Coast Hospital
- Bendigo Health Service
- Box Hill Hospital
- Footscray Hospital
- Frankston Hospital
- Goulburn Valley Base Hospital
- Royal Melbourne Hospital
- Southwest Healthcare (Warrnambool)
- St John of God Hospital
- St Vincent’s Hospital
- Sunshine Hospital
- The Northern Hospital
- University Hospital Geelong
- Werribee Mercy Hospital
Summary
Acute coronary syndrome (ACS) is a term used to describe a range of urgent conditions associated with sudden reduced blood flow to the heart. The most common conditions are heart attack and angina. It is vital to rule out life-threatening causes and provide timely treatment for these conditions.
In 2016, at the time of the project, approximately 2 per cent of Victorian emergency department (ED) admissions (42,000 patients) were for suspected ACS or chest pain.
Building on its previous work, Safer Care Victoria’s ECCN implemented and embedded a shorter, evidence-based process known as an ‘accelerated diagnostic pathway’ (ADP) to more efficiently assess patients for ACS in a number of emergency departments, reducing patients’ anxiety and their time in hospital.
Aims
- Reduce variation in practice and ensure evidence-based processes by more broadly implementing ADP processes for chest patients in EDs
- Reduce length of stay (LOS) for patients who are eligible for an ADP assessment to release ED capacity
Outcomes
- Reduced anxiety and inconvenience for patients by using an ADP approach to rule out ACS faster
- Reduced variation in practice and ensured the process of ruling out ACS was evidence-based
- Saved 20 minutes and released an estimated capacity of 472 patients in EDs implementing an ADP for the first time
- Increased the proportion of eligible patients assessed using an ADP from 22 per cent to 68 per cent in sites that completed ADP implementation
- Reduced the median LOS by between 15 and 83 minutes in almost all implementation sites
Update
December 2020 – The health services who participated in this project continue to use the ADP to provide a better experience for patients.