National Survey of Rapid Access Chest Pain Clinics in Australia.

Abstract

Background: Rapid access chest-pain clinics (RACC) are an innovative, outpatient pathway for low/intermediate-risk patients. Previous research has only included RACCs with published results, representing an academic subset. We identified and invited all RACCs to join a network and complete a national survey. Method(s): Australian RACCs were identified through four methods 1) systematic literature search; 2) Google Search using terms chest pain clinic with each state/territory, reviewed to 10th page; 3) word-of-mouth; 4) self-identified via the CSANZ emailing list. Result(s): Twenty-four RACCs were identified, located in all states/territories. All public (n=15/15, response rate=100%) and three private (n=3/9, response rate=33%) RACCs completed the survey. Service variations included: clinic days/week (median=3, range=1-7 days), patient volume (median=411.5, range=96-1,674 patients/year), staffing (all RACCs had at least 1 consultant, 13 RACCs had Ats, 10 had nursing staff, 3 BPT/SRMOs, and 3 had PGY1/2s), referral pathways (all accepted ED referrals, additional referrals from GPs in 12 RACCs, in-hospital/other clinics in 9), and use of telehealth (n=13). Median waiting times was 8.5 days (IQR=3.25-18 days), 50% of clinics reviewed >50% of patients within 7 days of referral, and 44% reviewed >=80% within 14 days. The most common initial investigations were stress echocardiography (7 clinics), CTCA (6 clinics), and exercise stress tests (5 clinics). All RACCs were agreeable/potentially agreeable to participate in multicentre studies if ethics and resources permitted. Conclusion(s): Our survey outlines the Australian RACC landscape, and the development of a national network to collaborate in multi-centre studies to improve our understanding of RACC on patient outcomes.Copyright � 2024