Authors (including presenting author) :
Tang KF (1), Chang JWY (2), Yiu KH (1), Law KL (2)
Affiliation :
(1)Department of Medicine (2) Department of Accident and Emergency, North District Hospital
Introduction :
Chest pain and heart failure contributes a significant amount of admissions especially during winter surge. In 2018 winter surge, collaboration between AED physician and cardiologists in emergency medicine ward (EMW) aim to reduce unnecessary admission.
Objectives :
(1)To minimized admission of low risk cardiac patient during winter surge
(2)Early identification of higher risk patient by cardiac team in order to smoothen patient journey
(3)Provide early point of care cardiac advise to patients & AED physicians
Methodology :
Patients admitted to emergency ward with diagnosis of chest pain & heart failure were selected out by AED physician. Cardiologists reviewed the patient in EMW and provided opinions include drug titration, optional point-of-care echocardiogram, early treadmill study to stratify patients’ risk in order to triage patient. Follow up plan would be given if patient deemed suitable for direct discharge, otherwise cardiac plan would be given for those admitted to facilitate patients’ care.
Result & Outcome :
From 17.12.2018 to 30.4.2019, 147 selected patients with either chest pain or heart failure were seen by cardiologists at EMW for further opinion. Point-of-care bedside echo were provided to 30.6% of patient and early treadmill test were provided to 19.7% of patient. There were 27.9% of patient require hospital admission to medical ward for further care. For those discharged patient, only 3.8% had readmission within 1week and 6.6% had readmission within 1month.
Early collaboration between AED physician and cardiologists in EMW smooth patients’ care pathway, reduce unnecessary hospital admission and avoid discharge of higher risk patient during winter surge.
