Bringing Early Attention To Heart Failure (BEAT-HF) symptoms and signs
What is the challenge your project is going to address and how does it connect to the theme?
The number of non-elective admissions to Blackpool Teaching Hospital with primary diagnosis of heart failure (HF) continues to rise despite a number of available interventions that have been shown to reduce admission rate.
Interventions can be delivered by either specialist teams or Primary Care practitioners to the diagnosed population but unfortunately a large number of patients face non elective admission before their diagnosis or any engagement of the specialist team.
Nationally 80% of patients had their HF diagnosis made during a hospital admission (Hayhoe 2017), locally 35% of admitted patients have their condition reported to the specialist team prior to admission.
Elective pathways include a rapid access HF clinic, HF nurse helpline, rapid access escalation clinics, Advice and Guidance.
Proposal; Community based, targeted diagnostic pathways following process mapping both elective and non-elective HF pathways with stakeholders, a ‘last 10 patients’ analysis, education, a measurement plan to understand variation, and impact of interventions.
What does your project aim to achieve?
Aim to reduce heart failure hospital admissions who are NOT on a current heart failure service case load, in the Fylde Coast by 20% . To share learning with the 4 neighbouring ICPs that form our ICS.
Project will identify variation in elective and non-elective HF pathway availability and access across The Fylde Coast and then beyond our ICP to Lancashire and South Cumbria with a view to reducing unwarranted variation and identifying special cause variation that might be associated with wider benefit through dissemination
How will the project be delivered?
· Collaboration across Health Economy
· Clearly defined elective heart failure pathways
· Communication strategy
· Accessible standardised electronic referral processes
· Improved access to diagnostics
· Address the perceived norms – funding, responsibilities, perceptions, beliefs
· Qualitative and quantitative data collection
· Engagement day
· Develop a Heart Failure hub
· Review current process with a view to identifying waste and improvement opportunities
· Publicity campaign – raise awareness amongst public and clinicians
· Develop patient stories, increase patient involvement
· Develop a locally evidenced intervention package
How is your project going to share learning?
There is high prevalence of heart failure on the Fylde Coast. This is in part the result of our demographic and particularly our deprivation index. However it also reflects the commitment to patient case finding of our established, multidisciplinary, cross health economy team.
However we continue to see hospital admission of patients without a HF diagnosis who have not been offered access to our non-elective service.
Once recognised by the specialist team, patient outcomes are impacted significantly. We have data that reports exemplary readmission rate, mortality and delivery of many aspects of evidence-based care. We have a track record of delivering improvement and are confident that this focus on the preadmission pathway with recent upskilling with regard to formal Quality Improvement strategies can be impactful and reproduceable.
The data that has driven our project and reported its impact will best support that dissemination alongside publication and presentation at National meetings.
How you can contribute
- We are keen to hear if publicity campaigns at local level have been associated with change in public/ patient/ clinician behaviour in the HF context. How were they delivered? What was successful and what was less so? How was success measured?
- Have other ICPs utilised continuous HF data reporting (SPC charts) as part of a QI approach to increasing patient and clinician engagement with elective diagnostic and engagement pathways?
- Have other ICPs engaged clinicians and administrative colleagues across health economy when process mapping elective and non-elective HF pathways? Have they identified misunderstanding / misconception from different perspectives? Anecdotally we have repeatedly but this is the first time we have looked to more objectively report and address the ‘norms’.
|1 Sep 2022||Faculty formed including patient representatives,|
|1 Oct 2022||commence development of digital IT processes|
|1 Oct 2022||identify project management and analytical support|
|1 Dec 2022||create promotional materials for all stakeholders|
|3 Jan 2023||create case studies, patient stories, materials to promote|
|1 Feb 2023||launch event with stakeholders|
|1 Feb 2023||share learning, publications, posters, conferences|