In this report the authors introduced a history based risk tool as part of a chest pain pathway into the ED for use by medical staff assessing patients presenting with chest pain. The intervention involved a nurse from cardiology engaging with clerical, nursing, and medical staff in the ED to ensure success of this quality improvement project.

The project showed a reduction in admissions to cardiology with suspected ACS from 29% to 15%, with a projected saving of £889 per patient who was prevented from being admitted. In addition, admissions became more appropriate, with an increase in the proportion of patients with a final diagnosis of ACS from 25% to 46% and a reduction in admissions with atypical chest pain from 75% to 5