The BMJ Awards 2017: Cardiology

Heart failure unit

Patients with heart failure rarely get optimum treatment in hospitals, despite their growing numbers and evidence that prompt diagnosis and treatment on cardiology wards can save lives. Some patients are dying unnecessarily, according to Lisa Anderson, consultant cardiologist at St George’s Hospital NHS Trust in London. Where you stay in hospital, when you get your diagnosis, and whether you receive the right medication are all critical.

Hamza Zafar, a clinical fellow in cardiology at the trust, says: “The problem was that patients were coming in with shortness of breath, being picked up as having a chest infection, staying in for a day, and then being sent home. After they had come back for three or four more visits they were finally referred to cardiology. We wanted to establish a unit where we could identify these patients sooner rather than later.”

Patients are now identified by examining chest x rays. “If we see any evidence of pulmonary oedema or congestion we’ll immediately pick up that patient and review for heart failure,” Hamza says. A heart failure unit was set up, initially with five beds and now 11, to provide optimum identification and treatment.

Results are much improved. Inpatient mortality is now 5.6% compared with 9.6% nationally; 30 day …