1. Primary Care Acute Chest Pain Awareness Project
Alison Turner & Marc Thomas
Project Managers
Cardiovascular Disease in Primary Care
PCCS/South Wales Cardiac Network
Wednesday 18 May 2011

2. Background
Myocardial Ischaemia National Audit Project (MINAP) report requested by WAG in 2007
Looked at data
Higher proportion of people in Wales called/visited their GP rather than calling 999 with chest pain

3. Background
MINAP Analysis – Network Level

4. Aims
To raise awareness within Primary Care of the importance of immediate admission via 999 for suspected MI
“1 minute delay = 11 days loss of life”1
To reduce
Pain-to-call time
Pain-to-needle/balloon time
¹Boersma E, Maas AC, Deckers JW, et al. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet 1996; 348 pp771-5

5. Project Implementation
Resources
Education and awareness sessions
Measurement of staff confidence and knowledge

6. Project Implementation
Pilot Study
Interim Analysis
Final Report

7. Pilot Implementation

8. Full Implementation

9. Outcomes
Beneficial to both clinical and non-clinical primary care staff
Staff confidence
Staff knowledge
Changes in practice

14. Admission Routes Comparing pre and post project implementation
Concerns
Were areas comparable?
Would improvements have happened anyway
NE England
SE Wales

20. Concerns
Increase in 999 calls for chest pain?

22. Incidental Benefits HM Prison Service Scotland GP
UK-wide implementation through BHF
Wider non-clinical public domains

23. Conclusion/Discussion
Demonstrable positive outcomes
Clinical and non-clinical impact
Generic resources
Same message for all reperfusion
Thrombolysis/pPCI
Value of educational component
Access to educational forums
?web-based package