None listed
Conditions
Brief summary
This project will evaluate the health services impacts of the recent introduction of the Seimen's Attellica high-sensitivity troponin assay across twenty Queensland Health Hospitals. The aim of the project is to compare the emergency department length of stay, hospital length of stay, the proportion of patients admitted and the proportion of patients undergoing cardiovascular testing in the pre- and post-implementation periods. The primary outcome is the proportion of patients who were discharged from the ED within four-hours of presentation for suspected acute myocardial infarction. Consecutive adult patients who presented to an emergency department with suspected acute myocardial infarction will be included. Six-months of pre- and six-months of post-implementation non-identifiable data will be sourced from several hospital databases including AUSLAB, the Emergency Data Collection minimum data set and the Queensland Hospital Admitted Patient Data Collection database. We anticipate approximately that 120,000 patients will be included in the pre- and post- implementation periods. We hypothesis that following the introduction of the Siemens Atellica high sensitivity troponin assay more patients will be discharged within four hours of ED presentation without an increase in the proportion of patients receiving cardiac angiography.
Interventions
The implementation of a new high sensitivity troponin into clinical care and associated clinical pathway utilised for the assessment of patients with suspected acute myocardial infarction (AMI) will be examined.
This will be a retrospective pre-post analysis of adult emergency patients presenting to 20 hospitals across Queensland. Six months of pre- and six months of post-implementation data will be included, with one month block out where no data is included for implementation will be collecte
The implementation of a new high sensitivity troponin into clinical care and associated clinical pathway utilised for the assessment of patients with suspected acute myocardial infarction (AMI) will be examined. This will be a retrospective pre-post analysis of adult emergency patients presenting to 20 hospitals across Queensland. Six months of pre- and six months of post-implementation data will be included, with one month block out where no data is included for implementation will be collected for each site. Due to staggered state-wide implementation, data will be collected from April 2021 to February 2023. Data will be obtained from existing hospital databases including the following: Emergency Data Collection (EDC) minimum data set, Queensland Hospital Admitted Patient Data Collection (QHAPDC) database, and Auslab. Consent will not be sought from patients and no direct patient involvement will be required. De-identified observational patient data will be examined from ED presentation to ED discharge or until hospital discharge if they are admitted. The following data will be collected: time to ED discharge, time to hospital discharge (if admitted) and cardiac investigations during hospitalisation including angiogram. The pre-implementation period for data collection is April 2021 to February 2022. The post-implementation period for data collection is April 2022 to February 2023.
Sponsors
Royal Brisbane and Women's Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients will be eligible for enrolment if they are 18 years of age or older and have at least one troponin test ordered within 3 hours of their presentation to the ED. Participants will be included in the pre-implementation group if presenting to a Queensland ED prior to implementation of the Siemen's Atellica assay between April 2021 and February 2022. Participants will be included in the post-implementation group if presenting to a Queensland ED where the Siemen's Atellica assay was implemented between April 2022 and February 2023.
Exclusion criteria
Patients will be excluded if they presented to the ED with troponin testing during the block-out implementation period relevant for each facility occurring between October 2021 and July 2022.
Outcome results
None listed