London Cardiovascular Project
Non elective cardiac surgery
Intro
A significant proportion of cardiac surgery conducted in London is on an urgent or non-elective basis.
Patients requiring urgent surgery often wait longer than they should. Clinical evidence shows that the risk of death increases month on month the longer a patient waits for surgery.
Implementation
The London Cardiac Networks are responsible for implementation with the South London Cardiac and Stroke Network leading the collaboration.
Project aims
Develop a new pathway that optimises an electronic referral system for inter-hospital transfer (IHT) patients.
A significant proportion of cardiac surgery conducted in London is on an urgent or non-elective basis.
To address the issues that exist, the clinical expert panel recommended the following for patients requiring non-elective cardiac surgery:
- Mandatory use of an electronic referral system for non-elective inter-hospital transfer patients
- Agreed evidence-based clinical protocols
- The panel also proposed that waiting times are monitored.
Waits should not exceed the following standards for 90% of firth time CABG patients:
- The total pathway length should not exceed 21 days
- The time between admission to the local hospital and referral to a surgical unit should not exceed five days
- Time between referral and transfer should not exceed five days
- Length of stay (LOS) at the surgical centre should be 11 days or less.
Implmentation update
- Site assessments have been completed in all non elective cardiac surgery sites with action plans developed to ensure full implementation by March 2012.
- Network teams have agreed analysis criteria for non elective IHT LOS reporting (first time isolated CABG).
- Data for non-elective patients will be captured on the inter-hospital transfer electronic referral system.
- To demonstrate the proportion of IHT patients referred electronically comparison will be made with Hospital Episode Statistics data.