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National award for scheme sending heart attack patients home sooner

HSJ award winners from St Bartholomew's Hospital

A Barts Health project which has cut the time spent in hospital for some heart attack patients by more than half has won a Health Service Journal award.

The ‘AMI early discharge pathway’ was established at the start of the Covid-19 pandemic by Barts Heart Centre clinicians concerned about a shortage of beds and the risk to patients of catching Covid whilst recovering in hospital.

Since its launch in April 2020, more than 1,300 patients have benefited from the scheme which has reduced the average stay in hospital from 78.9 to 27.5 hours.

Dan Jones, a consultant cardiologist at the Barts Heart Centre at St Bartholomew’s Hospital (pictured holding the award), said it is now the default pathway for 50% of our patients.

It has been adopted by other centres, includng the Glenfied Hospital in Leicestershire, and there are plans to take it nation-wide.

Acute myocardial infarction (AMI) is the medical name for a heart attack which occurs when blood flow to the heart is cut off, usually because of a blockage in one or more of the coronary arteries. It is commonly treated by primary percutaneous coronary intervention (PPCI), also known as an angioplasty or coronary angioplasty.

Guidelines recommend that some PPCI patients can be discharged between 48 and 72 hours after they are admitted to hospital.

Faced with a shortage of beds because of a spike in Covid cases and concerned about the impact of patients catching the virus, the team developed an algorithm to identify low risk patients, helping to free-up bed space without compromising patient safety.

For those safely discharged, follow-up appointments were moved online which boosted attendance and engagement. Feedback has been overwhelmingly positive. 83% of people said they were happy with the service and more than 95% would recommend it to a family member.

Crucially, no patients on the pathway contracted Covid-19 during their time in hospital and those sent home to recuperate with family or friends faced few complications.

Dan added: “The pandemic made us rethink the way we work and we’re delighted with the results so far. I would like to pay tribute to all of the teams involved in developing the pathway which could be rolled out at other heart centres across the UK.”

The project was successful in the acute sector innovation of the year award category.

Judges called it: "an impressive and highly innovative entry" with "clear criteria" and "improved outcomes".

The winner was announced at a ceremony on Thursday 17 November.

It means the masterminds behind the project are now mutli-award winning, having scooped the BMJ prize in the stroke and cardiovascular team category last year.

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