The Accelerated Chest Pain Risk Evaluation (ACRE) project is a statewide project supported by the Healthcare Improvement Unit. The ACRE project aims to facilitate implementation of the best evidence for the safe and efficient evaluation of patients presenting to emergency department (EDs) with possible cardiac chest pain. The project utilises clinical redesign methodology to support adoption of accelerated diagnostic protocols (ADPs) that are evidence-based, safe, and patient focused.
Since 2012, the ACRE project has worked with EDs across Queensland to implement the most current, evidence-based ADPs, thereby improving the evaluation of patients with possible cardiac chest pain. This has resulted in reduced length of stay (both ED and total hospital stay) and hospital admissions through implementation of protocols able to safely and rapidly assess patients at low and intermediate risk of Acute Coronary Syndrome (ACS).
From 2012 to 2015, the ACRE project initiated implementation of the ADAPT protocol in 19 hospitals. From 2016-2018, the Improved Assessment of Chest pain Trial (ImpACT) protocol was implemented in 9 hospitals.
With the introduction of the high sensitivity troponin assay in late 2018, the ACRE team is working with Queensland hospitals to promote the most effective utilisation of this assay by introducing accelerated patient management protocols. This includes facilitating the implementation of a 3 hour assessment timeframe for high risk patients in addition to the safe and efficient management of low and intermediate risk patients.
Due to upgrades to testing instruments, Pathology Queensland (PQ) are introducing a new high sensitivity cardiac troponin assay to all Queensland Health laboratories throughout 2022. For more information about the new troponin assay, visit the Resources page.