A groundbreaking new pilot scheme has demonstrated the ability to save heart failure patients at University Hospital Southampton 306 days spent in a hospital bed, resulting in an annual cost saving of £79,000 for the NHS.
The Rapid Response Project, spearheaded by specialist Heart Failure Nurse Esther Hall and part-funded by the regional cardiac charity Heartbeat, enabled a Heart Failure Nurse to closely monitor 149 patients from May 2022 to April 2023.
The aim of the project was to reduce the length of hospital stays for patients with heart failure by preventing direct admission, instead allowing patients to be treated in their own homes or allowing an early supported discharge. The nurse would visit patients at home to conduct comprehensive clinical examinations, ECGs, and blood monitoring.
In a time when community waiting lists and delayed patient reviews continue to grow due to the inevitable fallout from the COVID-19 pandemic, the Rapid Response project has proven essential in monitoring and enhancing heart failure services at University Hospital Southampton and potentially further afield.
The Pilot has been remarkably successful, preventing up to 35% of patients showing early signs of heart failure from being admitted to hospital. Timely treatment received within 3-7 working days also played a crucial role in achieving this outcome, emphasising the importance of a swift and efficient patient review service.
Furthermore, the project showcased that 27% of patients discharged early had further admissions prevented due to the early review. This achievement was made possible by the rapid response reviews conducted by the Heart Failure Specialist Nurse, typically occurring within 3-5 days.
The most common change in medication during these reviews was the prescription of Diuretics – a class of medications used to increase the removal of excess salt and water from the body through the kidneys – highlighting the significance of timely assessments in the post-discharge period.
Additionally, the project’s data indicated that patients on the faster discharge pathway and early review pathway had similar rates of hospital readmissions, underscoring that the quicker pathway was not only effective but also safe. Among the 149 patients seen, 114 were discharged to either the GP or other services, effectively reducing the workload on community teams and streamlining patient care.
Esther Hall said:
“The results from this Pilot have brought to light the immense potential for substantial improvements in patient care and cost savings for the healthcare system through timely interventions and comprehensive follow-up.
“By embracing similar strategies in heart failure services and beyond, the healthcare sector can continue to make significant strides in delivering efficient and effective care to patients in need.”
Following their hospital discharge, patients who required specific treatments during their inpatient stay were provided with follow-up care within two weeks. This included those needing medications delivered via an intravenous (IV) tube to eliminate excess fluid, extended use of IV medications for fluid removal, and dopamine administered through IV to enhance heart function and blood pressure.
Additionally, the criteria for receiving this follow-up care extended to patients who encountered complications during their hospital admissions. This covered abnormal rapid heart rhythms (tachyarrhythmias), cardiovascular instability (in which the patient’s heart and blood vessels were not functioning in a stable or normal manner), and acute kidney injury (AKI) necessitating fluid removal and medication adjustments based on their prognosis.
Ensuring comprehensive follow-up care for patients in these categories is crucial to monitor their progress, address any potential issues promptly, and optimise their recovery. By providing targeted and timely post-hospitalisation care, healthcare providers can significantly improve patient outcomes and reduce the risk of readmissions, further enhancing the effectiveness and efficiency of heart failure services.
Heartbeat, which donated £47,299 for the recharge of Esther Hall in the Rapid Response Heart Failure project, was thrilled with the project’s outcome.
CEO Mark Ind said:
“We are proud to have been part of this groundbreaking project that has proven to significantly improve heart failure care for patients at University Hospital Southampton.
“The successful outcome reaffirms the importance of investing in initiatives like this and highlights the life-changing impact such schemes can have on patients’ lives.
“At Heartbeat, we remain committed to driving advancements in cardiac care and look forward to supporting more initiatives that lead to better patient outcomes and a healthier community.”
To learn more about Heartbeat, please visit: heartbeat.co.uk.