Integrated working showcased in new report
Merged aortovascular on-call services between Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts have been showcased in a Getting It Right First Time (GIRFT) report on cardiothoracic surgery.
Cardiothoracic surgery is the surgical treatment of diseases of the organs contained within the chest, including the heart, major blood vessels and the lungs. The GIRFT review identifies significant opportunities to improve patient care and outcomes.
Demonstrated as a ‘Good practice case study’, this example of integrated working between the two trusts has seen one-year survival rates for patients undergoing Acute Aortic Dissection increase from 52% to 75%.
Specialist surgeons at both hospitals who perform more than 10 aortic procedures a year now belong to a shared 24 hour on-call rota. Together, with a new dedicated referral pathway for patients requiring Acute Aortic Dissection surgery, the merged rota has resulted in improved patient survival rates, shorter hospital stays, and a reduction in waiting time for patients between having their diagnostic computerised tomography (CT) scan to undergoing surgery.
A comparison of 141 cases pre-dating the start of the new rota with 125 cases since it has been in place identified the following improvements:
- CT scan to operation time fell from 650 minutes to 390 minutes
- in-hospital mortality fell from 25% to 14%
- median length of stay fell from 18 days to 12 days
- increased comprehensiveness of aortic repair
- blood product transfusion decreased
- composite complication outcome endpoint fell from 23% to 18% (included acute kidney injury, stroke, paraplegia, intensive treatment unit (ITU) stay of over one week).
King's Health Partners are bringing together our partnership’s collective clinical, research and educational expertise in cardiovascular disease to develop a world-class Cardiovascular Institute and Network.