1132 Model of Cardiology Service in District General Hospital

Abstract

Background: Various models of cardiology service are available in district general hospitals (DGH) in UK, like Joint cardiology clinics, Paediatric telecardiology, local paediatricians with expertise in cardiology (PEC) and cardiac technicians. Objective: To assess the Paediatric Cardiology Services provided by local PEC at Frimley Park Hospital by combining good clinical evaluation, echocardiography skills and support of tertiary paediatric cardiology centre in the absence of telemedicine. PEC attends once a week cardiology clinic at tertiary centre as honorary consultants. Design and Methods: Retrospective analysis of all the referrals to tertiary paediatric cardiology centre between October 2008 to February 2010. Data from the Proforma was collated in Excel and was analysed using simple statistical methods and percentage calculations. Results: 80/92 referrals were analysed. The reasons for referral were: clinical 82.5%, family history 5%, and rhythm disturbances 11%. Acyanotic congenital heart disease (CHD) was diagnosed in 64% (of which 64% left to right, 29.4% obstructive lesions and 8% regurgitant lesions) and 8.75% of cases were diagnosed as cyanotic CHD. All cyanotic CHD were picked up immediately after birth. 10% were found to have rhythm disturbances (SVT, WPW). 2.5% of cases were classed as life threatening. 20% required interventions and 12.5% of the referral were normal and discharged. Conclusions: Cardiology service provided by PEC with support from tertiary cardiology centre is safe and effective even in the absence of telemedicine. Weekly access to tertiary paediatric cardiology service by PEC provides continuous medical education, constructive feedback and opportunity to discuss non-urgent cases thereby avoiding unnecessary referrals.