Cardiologist: teamwork could save €21m a year

GETTING doctors, nurses and other health professionals working as a team in managing chronic medical conditions in hospital day wards could achieve huge savings for the health services, a cardiologist claimed yesterday.

Heart specialist at St Vincent’s University Hospital in Dublin Dr Ken McDonald said thenational application of the hospital’s teamwork approach to heart failure therapy could prevent 6,000 hospital admissions, free up almost 67,000 bed days and achieve savings of more than €21 million every year.

Intravenous diuretic therapy, developed at St Vincent’s, is being used on heart failure patients who would otherwise end up in accident and emergency departments and need a hospital stay.

Dr McDonald, who is also director of the Heartbeat Trust, a charity that works to improve care for those at risk of heart failure, said a 25-member team at St Vincent’s had been working on the chronic management of the condition for some time.

Doctors and nurses involved in the project found they were able to care for 80% of patients who would otherwise be required to stay overnight or longer in hospital.

“Patients love the service as it helps them to get well in familiar surroundings and helps avoid some of the more worrying risks of hospital stays, like infection,” said Dr McDonald.

He also pointed out that the success of St Vincent’s heart failure unit was borne out by the largest European study of nurse- led care of chronic heart failure.

Dr McDonald said the study, conducted in the Netherlands and not yet published, clearly showed the futility of doctors and nurses working in isolation from each other.

“This is a worrying trend which has begun to emerge across Europe and is usually driven by cost-cutting,” he warned.

Dr McDonald, who presented his findings at the annual meeting of the European Society of Cardiology on Heart Failure in Germany last week, stressed that the best outcomes for patients occurred when health professionals worked side by side.

“We have shown that the team approach works best, meaning that all aspects of care from medical decision-making to patient and family education are given the appropriate emphasis,” he said.

Dr McDonald said the project also fitted in with what the Health Service Executive wanted — the management of chronic disease within the community — and should be available at national level.