Evaluating the impact of rapid high sensitivity
troponin testing within a community hospital
emergency department: A pilot study
Ainslee Smith, Jinal Patel, Sachin Ramkission, Perry Guo,
Keri Kellachan, and Michelle Dimas
Background: Chest pain is a common presenting complaint
to emergency departments (EDs), and many low-risk patients
require serial troponin levels to rule out acute coronary syndrome (ACS) prior to discharge. Getting troponin level results
can take more than 1 hour, contributing to an increased length
of stay (LOS). Point-of-care or rapid testing can expedite these
testing and result times. The aim of this study was to evaluate
the workflow and feasibility of the QuidelTriage® MeterPro (a rapid testing meter) for high sensitivity troponin testing for lowrisk cardiac patients presenting with chest pain to the Oak Valley
Health (OVH) – Markham Stouffville Hospital (MSH) ED.
Methods: The Plan-Do-Study-Act (PDSA) cycle was used to
guide the implementation and evaluation of the QuidelTriage®
MeterPro, using TriageTrue® High Sensitivity Troponin I testing
within the ED. This pilot study evaluated the change in theoretical patient ED LOS and cost effectiveness of the device when
compared to standard of care (SOC) procedures and workflows.
Screening and recruitment was completed on weekdays within
the ambulatory zones of the ED for low-risk patients presenting
with chest pain requiring serial troponin testing. Patients consented to have extra blood drawn with their SOC bloodwork to
run the analysis on the meter. Rapid testing results were blinded
until data analysis.
Results: N = 19 patients participated in the pilot study from
February 2024 to September 2024. Interim data analysis showed
the average LOS for low-risk cardiac patients was 5 hours and
8 minutes. Results demonstrated that the meter (M) reported
faster troponin results than central lab processing (M = 16 min
and M = 1 hour and 2 min, respectively). Similarly, repeat troponin results demonstrated faster time to results using the meter
compared to central lab (M = 18 min and M = 53 min, respectively). In summary, using the meter could have reduced theoretical ED LOS to 3 hours and 47 min and lab waiting time by
70.43%. All results from the QuidelTriage® MeterPro matched
the results from the central lab Beckman Coulter-DXI600 analyzer. The cost analysis is being completed by the study team.
Implications and lessons learned: Implementation of a rapid
troponin testing meter, such as the QuidelTriage® MeterPro,
within the mobile lab at OVH – MSH ED, reduces troponin result time. This can improve workflows within the ED to
reduce physician reassessment time and ultimately reduce the
patients’ LOS. In some patient scenarios, rapid testing could
replace central lab testing. Rapid troponin testing devices have
the potential to optimize care within community and rural settings by improving throughput efficiency and by enabling the
rapid identification of acute cardiac events. Next steps include
further evaluation of the feasibility of rapid troponin testing for
high-risk cardiac patients, in addition to further cost analyses for
implementation planning.