Cho, Kenneth K; Kozor, Rebecca; Thiagalingam, Aravinda; Biasi, Adrian; Lennox-Bradley, Wendy; Mooney, John; Indraratna, Praveen; Pitney, Mark; Chetty, Riti; Ihdayhid, Abdul-Rahman; Hamilton-Craig, Christian; French, John; Favretti, Jackelyn; Thomas, Andrew; Davies, Allan; Black, James Andrew; Zoumberis, Chantelle; Al-Fiadh, Ali; Lowe, Harry; Kwan, Timothy; Leow, Kevin; Scott, Peter; Kangaharan, Nadarajah; Baumann, Angus; Spiro, Jon; Kalathil, Sonia; Evans, Geoffrey; Van Gaal, William; Filipopoulos, Benjamin; Shaw, Elizabeth; Chen, Xiaopeng; Chapman, Niamh; Reid, Christopher M; Figtree, Gemma A; Hillis, Graham S; Jennings, Garry; Chow, Clara K

Author(s)

Cho, Kenneth K

Kozor, Rebecca

Thiagalingam, Aravinda

Biasi, Adrian

Lennox-Bradley, Wendy

Mooney, John

Indraratna, Praveen

Pitney, Mark

Chetty, Riti

Ihdayhid, Abdul-Rahman

Hamilton-Craig, Christian

French, John

Favretti, Jackelyn

Thomas, Andrew

Davies, Allan

Black, James Andrew

Zoumberis, Chantelle

Al-Fiadh, Ali

Lowe, Harry

Kwan, Timothy

Leow, Kevin

Scott, Peter

Kangaharan, Nadarajah

Baumann, Angus

Spiro, Jon

Kalathil, Sonia

Evans, Geoffrey

Van Gaal, William

Filipopoulos, Benjamin

Shaw, Elizabeth

Chen, Xiaopeng

Chapman, Niamh

Reid, Christopher M

Figtree, Gemma A

Hillis, Graham S

Jennings, Garry

Chow, Clara K

Publication Date

2025-05-22

Abstract

Rapid access chest pain clinics (RACCs) are an innovative outpatient pathway that allows low-intermediate risk patients to avoid hospitalisation. However, the extent of RACCs in Australia is unknown. We aimed to identify Australian RACCs and describe the characteristics and landscape of this model of care in Australia.Australian RACCs were identified through four pathways: 1) Systematic literature search; 2) Google Search; 3) Word of mouth via RACC leaders including through the National Health and Medical Research Council Translation Centres that form the membership of the Australian Health Research Alliance; and 4) through the Cardiac Society of Australia and New Zealand emailing list. All RACCs identified were invited to complete a survey exploring the clinic's characteristics.Twenty-five (25) RACCs were identified, and present in all Australian states and territories. All public (n=16 of 16, response rate=100%) and three private (n=3 of nine, response rate=33%) RACCs completed the survey, with most RACCs located in major cities (n=14, 74%). In the 2022 calendar year, responding RACCs reported assessing 7,718 patients. RACCs had a median waiting time of 8.5 days (interquartile range [IQR] 4-18 days), 10 RACCs assessed >50% of patients within 7 days of referral, and 11 RACCs assessed ≥80% of patients within 14 days. Service variations included: clinic days/week (median=3; IQR 1.25-4 days), patient volume (median=335; IQR 130-600; range, 96-1,674 patients/yr), staffing (all RACCs had at least one consultant), other RACCs involved cardiology advanced trainees (n=13), nursing staff (n=11), basic physician trainees or senior resident medical officers, that is, post-graduate year (PGY) 3+ (n=2), and PGY1/PGY2s (n=3). All clinics accepted emergency department referrals (n=19), with additional referrals from general practitioners in 12 RACCs, and in-hospital/other clinic referrals in nine. Telehealth was used in 13 clinics. The most common initial investigation was stress echocardiography (eight clinics), computed tomography coronary angiogram (six clinics), and exercise stress test (five clinics).Our survey is the first to describe the national implementation of RACC and map the delivery of care in Australia. An additional outcome is the development of a national network of centres to collaboratively develop a "best practice" model of care for RACCs to improve patient outcomes.

Affiliation

Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia.

Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia.

Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia.

Department of Cardiology, Gosford Hospital, Gosford, NSW, Australia.

Department of Cardiology, Prince of Wales Hospital, School of Clinical Medicine, UNSW Sydney, Randwick, NSW, Australia.

Sutherland Heart Clinic, Caringbah, NSW, Australia.

Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, Australia.

Faculty of Medicine, The University of Queensland, Herston, Qld, Australia.

Department of Cardiology, Liverpool Hospital, Liverpool, NSW, Australia.

Department of Cardiology, John Hunter Hospital, New Lambton Heights NSW, Australia.

Department of Cardiology, Royal Hobart Hospital, Menzies Institute for Medical Research University of Tasmania Hobart, Tas, Australia.

Department of Cardiology, Austin Health, Heidelberg, Vic, Australia.

Department of Cardiology, Concord Hospital, Concord, NSW, Australia.

Department of Cardiology, Canberra Hospital, Garran, ACT, Australia.

Department of Cardiology, Royal Darwin Hospital, Tiwi, NT, Australia.

Department of Cardiology, Alice Springs Hospital, The Gap, NT, Australia.

Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.

Charles Clinic Heart Care, Launceston, Tas, Australia.

Department of Cardiology, Northern Health, Epping, Vic, Australia.

Department of Cardiology, Hornsby Hospital, Hornsby, NSW, Australia.

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.

Western Australian Health Translation Network, Perth, WA, Australia.

Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia; Sydney Health Partners, The University of Sydney, NSW, Australia.

Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.

Sydney Health Partners, The University of Sydney, NSW, Australia.

Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia; Sydney Health Partners, The University of Sydney, NSW, Australia. Electronic address: Clara.chow@sydney.edu.au.

Citation

Heart Lung Circ . 2025 May 22:S1443-9506(24)01966-8. doi: 10.1016/j.hlc.2024.12.006. Online ahead of print.

ISSN

1444-2892

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/40410111/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/14285

Subject

Cardiology clinic

Chest pain

Rapid access cardiology

Title

National Survey of Rapid Access Chest Pain Clinics in Australia.

Type of document

Journal Article

Entity Type

Publication

NT Health Research and Publications Online

National Survey of Rapid Access Chest Pain Clinics in Australia.

Files:

Author(s)	Cho, Kenneth K Kozor, Rebecca Thiagalingam, Aravinda Biasi, Adrian Lennox-Bradley, Wendy Mooney, John Indraratna, Praveen Pitney, Mark Chetty, Riti Ihdayhid, Abdul-Rahman Hamilton-Craig, Christian French, John Favretti, Jackelyn Thomas, Andrew Davies, Allan Black, James Andrew Zoumberis, Chantelle Al-Fiadh, Ali Lowe, Harry Kwan, Timothy Leow, Kevin Scott, Peter Kangaharan, Nadarajah Baumann, Angus Spiro, Jon Kalathil, Sonia Evans, Geoffrey Van Gaal, William Filipopoulos, Benjamin Shaw, Elizabeth Chen, Xiaopeng Chapman, Niamh Reid, Christopher M Figtree, Gemma A Hillis, Graham S Jennings, Garry Chow, Clara K
Publication Date	2025-05-22
Abstract	Rapid access chest pain clinics (RACCs) are an innovative outpatient pathway that allows low-intermediate risk patients to avoid hospitalisation. However, the extent of RACCs in Australia is unknown. We aimed to identify Australian RACCs and describe the characteristics and landscape of this model of care in Australia.Australian RACCs were identified through four pathways: 1) Systematic literature search; 2) Google Search; 3) Word of mouth via RACC leaders including through the National Health and Medical Research Council Translation Centres that form the membership of the Australian Health Research Alliance; and 4) through the Cardiac Society of Australia and New Zealand emailing list. All RACCs identified were invited to complete a survey exploring the clinic's characteristics.Twenty-five (25) RACCs were identified, and present in all Australian states and territories. All public (n=16 of 16, response rate=100%) and three private (n=3 of nine, response rate=33%) RACCs completed the survey, with most RACCs located in major cities (n=14, 74%). In the 2022 calendar year, responding RACCs reported assessing 7,718 patients. RACCs had a median waiting time of 8.5 days (interquartile range [IQR] 4-18 days), 10 RACCs assessed >50% of patients within 7 days of referral, and 11 RACCs assessed ≥80% of patients within 14 days. Service variations included: clinic days/week (median=3; IQR 1.25-4 days), patient volume (median=335; IQR 130-600; range, 96-1,674 patients/yr), staffing (all RACCs had at least one consultant), other RACCs involved cardiology advanced trainees (n=13), nursing staff (n=11), basic physician trainees or senior resident medical officers, that is, post-graduate year (PGY) 3+ (n=2), and PGY1/PGY2s (n=3). All clinics accepted emergency department referrals (n=19), with additional referrals from general practitioners in 12 RACCs, and in-hospital/other clinic referrals in nine. Telehealth was used in 13 clinics. The most common initial investigation was stress echocardiography (eight clinics), computed tomography coronary angiogram (six clinics), and exercise stress test (five clinics).Our survey is the first to describe the national implementation of RACC and map the delivery of care in Australia. An additional outcome is the development of a national network of centres to collaboratively develop a "best practice" model of care for RACCs to improve patient outcomes.
Affiliation	Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia. Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia. Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia. Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia. Department of Cardiology, Gosford Hospital, Gosford, NSW, Australia. Department of Cardiology, Gosford Hospital, Gosford, NSW, Australia. Department of Cardiology, Prince of Wales Hospital, School of Clinical Medicine, UNSW Sydney, Randwick, NSW, Australia. Sutherland Heart Clinic, Caringbah, NSW, Australia. Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, Australia. Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, Australia. Faculty of Medicine, The University of Queensland, Herston, Qld, Australia. Department of Cardiology, Liverpool Hospital, Liverpool, NSW, Australia. Department of Cardiology, Liverpool Hospital, Liverpool, NSW, Australia. Department of Cardiology, Liverpool Hospital, Liverpool, NSW, Australia. Department of Cardiology, John Hunter Hospital, New Lambton Heights NSW, Australia. Department of Cardiology, Royal Hobart Hospital, Menzies Institute for Medical Research University of Tasmania Hobart, Tas, Australia. Department of Cardiology, Austin Health, Heidelberg, Vic, Australia. Department of Cardiology, Austin Health, Heidelberg, Vic, Australia. Department of Cardiology, Concord Hospital, Concord, NSW, Australia. Department of Cardiology, Concord Hospital, Concord, NSW, Australia. Department of Cardiology, Canberra Hospital, Garran, ACT, Australia. Department of Cardiology, Canberra Hospital, Garran, ACT, Australia. Department of Cardiology, Royal Darwin Hospital, Tiwi, NT, Australia. Department of Cardiology, Alice Springs Hospital, The Gap, NT, Australia. Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia. Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia. Charles Clinic Heart Care, Launceston, Tas, Australia. Department of Cardiology, Northern Health, Epping, Vic, Australia. Department of Cardiology, Northern Health, Epping, Vic, Australia. Department of Cardiology, Hornsby Hospital, Hornsby, NSW, Australia. Department of Cardiology, Hornsby Hospital, Hornsby, NSW, Australia. School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia. Western Australian Health Translation Network, Perth, WA, Australia. Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia; Sydney Health Partners, The University of Sydney, NSW, Australia. Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia. Sydney Health Partners, The University of Sydney, NSW, Australia. Department of Cardiology, Westmead Hospital, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia; Sydney Health Partners, The University of Sydney, NSW, Australia. Electronic address: Clara.chow@sydney.edu.au.
Citation	Heart Lung Circ . 2025 May 22:S1443-9506(24)01966-8. doi: 10.1016/j.hlc.2024.12.006. Online ahead of print.
ISSN	1444-2892
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/40410111/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/14285
Subject	Cardiology clinic Chest pain Rapid access cardiology
Title	National Survey of Rapid Access Chest Pain Clinics in Australia.
Type of document	Journal Article
Entity Type	Publication