Enhancing emergency cardiac care delivery: structured induction programme improves frontline doctors' acute care competencies and reduces critical decision uncertainty

In acute cardiac emergencies, patient outcomes are heavily influenced by frontline doctors' initial clinical decisions. The critical transition period for new doctors has been associated with increased medical errors in emergency care settings [1,2]. While standard training exists, current induction methods rarely address time-critical decision-making and emergency protocol adherence in acute cardiac scenarios, potentially compromising rapid care delivery.

To evaluate whether a comprehensive, emergency-focused cardiology induction programme improves frontline doctors' acute response capabilities, enhances critical decision-making, and optimises rapid cardiac care delivery through improved emergency protocol adherence and acute team integration.

We developed a structured acute cardiology induction programme focusing on emergency cardiac care delivery. The programme embedded critical care protocols for time-sensitive conditions including STEMI, NSTEMI, cardiogenic shock, and life-threatening arrhythmias, with emphasis on rapid assessment, emergency interventions, and acute care handovers. Resident doctors (n=15) rotating through cardiology, from 2023 to 2024, completed validated assessments of their emergency care competencies before and after implementation, using a 5-point Likert scale focusing on acute care domains.

Significant improvements in acute care delivery were demonstrated: understanding of emergency protocols (mean difference 2.53, p<0.001), confidence in critical decision-making (mean difference 1.80, p<0.001), and preparedness for acute team integration (mean difference 2.06, p<0.001). The programme received high ratings for emergency care guidance (4.60/5) and comprehensive coverage of acute scenarios (4.33/5). Notably, 93.3% of participants reported enhanced preparedness for managing acute cardiac emergencies. Qualitative feedback emphasised improved confidence in critical care delivery and emergency decision-making.

This acute care initiative demonstrates significant potential for optimising emergency cardiac care delivery through systematic preparation of frontline clinicians. Despite pilot scale, the magnitude of improvement suggests meaningful impact on acute care delivery. While larger-scale validation is planned, these preliminary findings provide a promising framework for enhancing emergency cardiovascular care in acute settings. Implementation of similar emergency-focused approaches could help standardise and optimise care delivery during critical cardiac presentations.