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months pre-implementation at each site were compared to 16 months post-implementation data. Results: Median total hospital LOS fell by 404 min (95% CI: 370-437 min) from 1210mins (IQR: 511-3494) to 806mins (IQR: 368-2300). ED LOS fell from 230mins (IQR: 163-352) to 213mins (IQR 150-307). There was an absolute decrease in hospital admissions of 13.1% (95% CI: 12.3-13.9%) from 70.4% to 57.3%. 5815 patients were managed on the ADP, accounting for 23.2% (95% CI; 22.7-23.8%) of possible cardiac chest pain presentations and closely matching ADAPT. Conclusion: The ADAPT ADP is applicable to routine clinical practice across a broad range of hospitals. Implementation had a profound positive impact on hospital LOS and admission rates for patients presenting with possible cardiac chest pain.