The NHN works within four domains in cardiology – atrial fibrillation, coronary artery disease, heart failure and heart valve disease – and each has its own working group that includes family doctors, cardiologists and cardiac surgeons.
An illustrative problem we faced five years ago was that care pathways for atrial fibrillation did not match between the various care-givers. This would then impact the quality of the patient’s referral appointment, which might only last 15 or 20 minutes. This could cause stress to the patient and might even complicate the condition.
We have introduced screening tools for family doctors to aid diagnosis of atrial fibrillation, which is a leading cause of stroke among the elderly, and other conditions. This screening tool helps the family doctor understand next steps – they can easily find information regarding the best care pathways on our website and send this patient to a hospital if needed. We have developed new, protocolized outpatient clinics, where the patient will see a nurse specializing in, for example, care for atrial fibrillation or heart failure. The patient is better informed and the nurse is trained in collecting the data we would need for a quality assessment.
We’re now in the process of assessing costs before and after the establishment of these new care pathways. The preliminary data is proving that we are right in our concepts: we know that the quality of care is improving and we’ll have the final cost assessment very soon.