544 Role of Medical Tutor Specialist With Cardiology Background in the Assessment and Diagnostic Unit; The North Shore Hospital Experience

Abstract

Hospital presentations due to cardiac diseases occupy a significant percentage of hospital admissions. Patients with other medical problems often have a concomitant acute cardiac issue. Having a cardiologist on-site in the admission and discharge unit aims to reduce the time for patients needing acute cardiology input and improves patient flow. For the first time a medical tutor specialist (MTS) role was offered to a newly trained cardiologist at North Shore hospital. The role included five on-site sessions per week in the assessment and diagnostic unit (ADU). During these sessions, the MTS provided support to junior medical staff with reviews and advice on patients requiring cardiology input. We audited 150 patients comparing whether an MTS was on-site versus standard of care (SoC). Each arm contained 50 patients, one MTS arm and two arms of SoC at different times. We compared the time to decision making, agreement with a senior cardiologist and outcomes followed up for 2 months. 78% of patients were seen within 1 hour with appropriate advice given while cardiologist is on-site compared with 16% of patients in the standard of care arm. Decision agreement with a senior cardiologist was observed in 86% of patients in the MTS arm compared to 26%. Earlier transfers to wards or earlier discharge were recorded in 68% of cases in the MTS compared to 17%. There were no adverse outcomes noted in either group. Providing more cardiology support to the ADU yields to improving patients flow and probably shorter hospital stay.