What is it?
A high sensitivity blood test to detect Troponin that helps staff in Emergency Departments rule-out myocardial infarction (‘heart-attack’) more quickly and direct patients to the appropriate care.
Two blood tests are performed up to three hours apart compared to traditional sequential blood testing of up to 12 hours. Studies demonstrated that over 75% of patients were rapidly ruled ‘out’ or ‘in’ in the ED and around 70% could be discharged earlier.
As a consequence this could lead to patients spending less time in emergency departments and fewer unnecessary admissions to hospital.
The pilots and evidence to date have led to the application of a validated rapid protocol and NICE DG15 guidance. The NICE adoption toolkit is now available to support implementation for providers.
The Royal Wolverhampton National Health Service (NHS) Trust has implemented an integrated clinical care project to optimise pathways for patients with suspected Acute Coronary Syndrome (ACS). By using high sensitivity troponin and clinical assessment on arrival at Accident and Emergency, doctors have been able to reduce total length of stay for patients from arrival to discharge from 23 hours to 9.6 hours (a greater than two-fold reduction) and reduce the number of patients admitted unnecessarily by 37% (from 60.9% to 38.4%).
The new ACS patient process at The Royal Wolverhampton NHS Trust reduced the annual healthcare spend by approximately £788,000 due to reduced admissions with safe and fast, high-quality care.
What are the benefits?
- Improved management of patients and patient experience
- Potential to reduce time-to-discharge
- Standardised care potentially reducing length of stay in the ED
Where to start?
- NICE have produced an adoption support resource with insights from the NHS to get started
- NICE has also published this case study to their website.
- NICE Guidance DG15
- NHS England Innovation and Technology Payment
- AHSN Innovation and Technology Payment: High-Sensitivity Troponin
- NICE approved suppliers (as part of an early rule out protocol): Abbott and Roche
- Email: firstname.lastname@example.org
- AHSN lead: South West AHSN