We will ensure that all BC emergency departments provide efficient and safe disposition for chest pain patients with potential ischemic chest pain.

• Initiated development of study to evaluate high-sensitivity troponin in chest pain management
• Recruitment of partners in cardiology and laboratory medicine for hsTnT study
• Initiated data collection for study of fractional flow reserve CT (FFR CT) in management of chest pain patients
• Ongoing relationships with radiology and cardiology partners in FFR CT study

• Test implementation of a two-hour discharge rule for chest pain patients
• Implement rapid diagnostic testing of chest pain patients at triage
• Synthesize and implement a comprehensive clinical pathway for patients with chest pain that incorporates:
  • Triage-ordered testing
  • A validated two-hour rule-out clinical decision rule
  • A six-hour strategy with rapid out-patient stress tests
• Find resources to follow patients in order to evaluate the strategy in St. Paul’s Hospital and in other settings in BC

• Integrate new and existing knowledge into a comprehensive framework for safe and efficient diagnosis and disposition of patients with potential ischemic chest pain presenting at all BC emergency departments (ED)
• Quantitatively measure the decrease in ED and hospital resource use by implementing such a framework