Requirements for the delivery of an Australian Rapid Access Chest Pain Clinic

Abstract

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.