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National award for scheme sending heart attack patients home sooner

A Barts Health project which has cut the time spent in hospital for some heart attack patients by more than half has won a BMJ 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 last year, more than 700 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 said it is now the default pathway for 50% of patients.

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 (pictured receiving their award from British Cardiovascular Society president John Greenwood) 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 stroke and cardiovascular team category.

The winner was announced at a virtual ceremony which took place on Wednesday 29 September.

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