Aims To assess the impact of a paediatrician with expertise in cardiology triaging referrals to specialist outreach clinics.
Methods A retrospective study comparing the activity in specialist paediatric cardiology outreach clinics led by the same cardiologist in two teaching hospitals between January and June 2011. One hospital had a Consultant Paediatrician with expertise in cardiology (PEC) running clinics to review all cardiology referrals prior to review by the specialist cardiologist. Data analysed for this review included a) referral indication b) referral source c) investigations performed and d) discharge or follow-up outcome. Clinics led by a PEC were also evaluated to determine the total workload in a non- cardiac centre.
Results The PEC clinic saw a total of 580 patients between January and June 2011: 348 (60%) were discharged, 26 (4%) referred to the specialist outreach clinic and 206 (36%) followed up again by the PEC. The activity in the specialist outreach cardiology clinics is shown in the table 1.
▶ 66% of new referrals to a specialist outreach clinic without PEC support were discharged after initial assessment.
▶ 35% of new referrals attending a specialist clinic supported by PEC have some form of intervention compared to 6% in a non-PEC clinic.
Conclusions There are differences in the referral pattern and outcome of the outreach clinics. Triage of referrals by PECs reduces assessment structurally normal hearts within specialist outreach clinics and also results in higher intervention rates compared to a non-PEC triaged group. Our data supports paediatricians with expertise in cardiology becoming an established part of the cardiology services framework. This will have both economic and clinical impact; by reducing the unnecessary burden on joint cardiac clinics and therefore providing a better service for patients with complex cardiac disease.