Nurse Co-ordinated
Rapid Access Chest Pain
Clinic
The Belfast City Hospital Experience
Str Helen Greene
Clinical Nurse Specialist
Coronary heart disease is the most common
cause of death in the UK, with around one in
five men and one in seven women dying from
the disease.
It is also the most common cause of premature
death (<75yrs), accounting for 19% of men and
10% of women.
Allender. S et al 2008 . Coronary heart disease statistics. British Heart Foundation, London
Guidelines
The Rapid Access Chest Pain Clinic was initially
set up as a response to the National Service
Framework guidelines for Coronary Heart
Disease (2000). As a means of improving the
patients experience.
► The RACPC was first opened in 2002.
► To date Approximately 9000 patients have
been seen.
► Average 1000 patients per year.
Patients are referred from GPs.
► Presenting with symptoms suggestive of
coronary artery disease (CAD)
♦ No previous history of CAD
♦ Previous history of CAD with worsening
symptoms.
The patient experience:
►Blood samples
►Clinical history
►Physical examination
►ECG, BP
►Exercise stress testing (EST)
►Results and management plan (inc meds)
EST outcomes
Positive
Negative
13%
9%
78%
Equivocal
Coronary Angiography Outcomes
PCI : Stent insertion
CABG : Coronary artery
bypass grafting
CABG
PCI
MED Mx
6%
23%
20%
Med Mx: Medical
management
NCA: Normal coronary
arteries
51%
NCA
Satisfaction surveys:
GP and Patient satisfaction surveys every
2 years.
GP’s - 100% very satisfied with the service.
Patients – 100% very satisfied.
Conclusion:
Key word is Rapid
►Rapid appointment allocation
►Patient results on the day
►Rapid referral for further investigation
(therefore reducing waiting times)
►Commencement of medication by nurse
prescriber
►GP results within 24 hours
Questions?