Requirements for the delivery of an Australian Rapid Access Chest Pain Clinic
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Background
Rapid Access Chest Pain Clinics (RACPCs) are outpatient cardiac services designed to promptly assess and manage patients experiencing chest pain. Despite the establishment of 25 RACPCs across Australia, a standardised implementation framework has yet to be developed. This study aimed to identify the core components of successful delivery of an existing RACPC.
Methods
A qualitative process evaluation study was conducted at a RACPC in a metropolitan, tertiary hospital in Tasmania, Australia, from November 2022 to July 2023. Clinical observations and semi-structured interviews were conducted with seven RACPC clinicians. Deductive data analysis was undertaken according to a Context-Mechanism-Outcome framework.
Results
Core components of successful RACPC delivery included: (1) a multidisciplinary team-based approach to care with discreet clinical roles; (2) timely patient review by RACPC clinicians within 30 days of referral; (3) embedded patient education; (4) ongoing clinical team training and education; and (5) a shared understanding of the RACPC service’s identity and purpose. Challenges to RACPC delivery were also identified and included resource constraints and administrative burdens.
Conclusions
Successful delivery of a RACPC model of care relies on a range of interrelated factors. These findings align with the broader theme of ongoing health service evaluation as a driver for continuous quality improvement and care standards within RACPCs. Further research aimed at developing and implementing effective strategies to enhance service delivery is needed to determine a national model of care.
