Changes made by an LiA team at St George's Healthcare NHS Trust have radically transformed the process for Cardiac Murmur Test results, and this has had a very positive impact on the patient experience.
The reporting of cardiac investigations by Cardiologists at St George’s was subject to capacity issues. This resulted in significant delays – on average 5 weeks – between the investigation being performed by the Cardiac physiologists and the results being sent to GPs for onward communication to the patient. This was confirmed by a year-long retrospective audit of the Murmur Clinic, which investigates abnormal heart sounds. A patient experience survey also reported low levels of satisfaction with the waiting times for results, although the service held up well overall.
The Cardiology team at Queen Mary’s Hospital, Roehampton, were keen to change their reporting procedures. They knew that their fire-fighting attempts to minimise delays were not sustainable and that a permanent solution had to be found.
Using the Listening into Action (LiA) approach, the Cardiology team quickly identified that by making the clinic physiologist-led, they would be able to achieve a same-day service. This would speed up the service for patients and free up consultants to focus on more complex and urgent issues.
To do this the team undertook a patient survey, consulted GPs, reviewed the patient pathway, created new templates with extended slots, arranged the necessary training for staff, sought accreditation with the British Society of Echocardiography (BSE), reviewed appropriate policies and protocols to codify practice, and agreed a business plan and risk assessment with their Divisional Management and Governance Boards.
This was not without its hurdles, but the focus remained the improvement of clinical effectiveness, patient experience and patient safety.
Nolan Stain, Cardiology Manager said: “The staff engagement approach provided by Listening into Action gave us the perfect starting point, with a structure and set timeframe. By involving all the right people - across the usual boundaries - right from the start, we knew that we were working towards something with the full support of a broad multi-disciplinary team and for the benefit of our patients”.
The physiologist-led Murmur Clinic went live on Friday 30th May 2014. The results will be audited at 3 months, 6 months and 12 months to ensure compliance with agreed standards. So far, the team has achieved the same-day target at 100% and the 5 week wait has been completely eradicated.