gov - Right Care, Right Place, Right Time - Patient impact of the Sláintecare Integration Fund. 9th December 2021.

The 15th Sláintecare webinar focused on patient impact of the Sláintecare Integration Fund. These projects are testing new ways in which we can bring care closer to home, including putting the patient at the centre of service design and delivery. These projects show how joined-up thinking and working in partnership can help us reach Sláintecare’s goals of shifting care to the community, and improving experiences for patients.

Integrated Community Chest Pain Clinic

9% of all visits to ED are due to chest pain, and only a small proportion of these are acute. Shirley Ingram, Advanced Nurse Practitioner in Cardiology began to notice a pattern during the ten years she had been working in the Tallaght University Hospital Emergency Department examining patients presenting with chest pain. Approximately one third of patients had chest pain that was non-acute. These patients had been referred by GPs, as there is no other option for patients to be seen quickly.

Shirley applied for Sláintecare funding, allowing her to bring her vision of a Community Chest Pain Clinic to life. The Integrated Community Chest Pain Clinic treats patients referred from their GPs with non-acute chest pain.

Over 500 patients have come through the clinic since it opened, and
There has been a 15% reduction in GP referrals for patients with chest pain to ED,
One third of patients have not required any further investigation,
The team has engaged with 112 GPs, with regular referrals now coming from some of these.

Patient education and contact with patients has been a huge part of the success of the project, and Shirley credits the wider team. Administration, Physiology, Cardiology all allow this service to practice efficiently and safely for the benefit of the patient.

Towards Self-Care in Headache

Professor Orla Hardiman joined us on this webinar to explain the project Towards Self Care in Headache. 800,000 people in Ireland have a neurological issue, and there are 21,000 people on a waiting list for a neurological appointment in Ireland. Between 25% and 30% of people on those waiting lists were referred for headache. Headache was the seventh most common reason for attendance at the Emergency Department, and the second most common reason for attendance at Medical Assessment Units. Professor Hardiman and her team determined that by joining up services across the hospital and community, patients could be assessed in a more appropriate setting.

The project was piloted across three sites in Galway, Tallaght and St. James’s Hospital, with teams involving neurologists, Clinical Nurse Specialists, a Psychologist and Administration or Research support. The Migraine Association of Ireland has partnered with the project to streamline services available to patients, especially psychology support groups in the community.

New patient pathways have been key to improving the patient experience, and for a more timely and appropriate service for patients. GPs refer patients to a CNS within the service, who may then refer the patient for specific diagnostics and then create a care pathway. Patient education and self-management are also a key aspect of the improved patient pathway and experience. Prof. Hardiman highlights the value of knitting together the services of the Migraine Association of Ireland and the services offered in the acute service to deliver a truly patient-centred service.