This grant proposal directly aligns with a Ministry of Health initiative to implement an accelerated assessment pathway for suspected acute ischaemic heart disease into the regional service frameworks. The study will pilot implementation of a new accelerated diagnostic pathway/protocol for suspected acute coronary syndromes across New Zealand district health boards. The pathway was developed in New Zealand and Australia and has undergone successful observational and randomised controlled trials published in international journals. Of the thousands of patients who present to New Zealand emergency departments every year with suspected cardiac chest pain, approximately 20% could be discharged early. Large volumes of patients who do not have cardiac chest pain will be sent home early, reducing patient worry, increasing clinician availability to acutely ill patients, reducing emergency department overcrowding, reducing unnecessary inpatient admissions, and thereby reducing unnecessary healthcare costs.