Bridgwater Community Hospital has deployed a new telemedicine ECG service from Broomwell HealthWatch to provide expert cardiology reporting for patients attending its Urgent Treatment Centre.
The centre, based in Somerset, provides unscheduled care for almost 20,000 patients per year and chose to use the telemedicine software to help reduce pressures on healthcare providers within the trust.
Michael Paynter, nurse practitioner in emergency care at the centre, told E-Health Insider: “As we do not regularly perform ECGs, there is a noticeable deteriation in the degree of skills we have and this gap in knowledge needs to be filled. Previously, we were just a minor injuries unit before our service was redesigned and redefined and so with our new responsibilities we felt we needed additional resources to help treat extreme trauma injuries.
“I’d seen evidence of the benefits of Broomwell’s telemedicine service and felt it would be a valuable asset for our practice and so I approached our PCT for funding and we began a six week trial, which was accredited by the NHS.”
With only an estimated 5% of patients requiring an ECG as part of their clinical assessment, the cardiac monitoring service at Broomwell HealthWatch offers non-cardiology clinicians expert support, enabling them to make more informed clinical decisions and provide robust risk management.
Broomwell’s cardiac monitoring and response service has been used for over 600 patients at Bridgwater to date. It has proven to be a vital diagnostic aid for emergency nurse practitioners in both making informed clinical decisions and improving clinical outcomes.
“The trial worked superbly well and offered us some valuable expert cardiology opinions, which were certainly needed by junior medical staff and GPs. The clinical decision rests with the emergency nurse practitioner managing the case. Broomwell comes up with useful suggestions, and has helped to prevent unnecessary referrals, thus avoiding adding to existing pressures,” Paynter said.
The service has already proven effective in saving lives in cases where patients’ symptoms are not so obvious, Paynter said.
“Recently, when a patient attended having fallen and sustained a fractured wrist, the nurse practitioner identified a slow heart rate and performed a 12 lead ECG, which indicated a profound bradycardia with heart block.
“Broomwell’s service confirmed the ECG as a complete heart block and the patient was transferred directly to the acute hospital’s coronary care unit for pacing. Without this service and the astute observation of the nurse practitioner the heart block could possibly have been overlooked with potentially devastating outcomes.”
The ECG reporting service has also delivered clear cost benefits on a wider cross-trust scale. It has reduced the number of patient referrals to the local acute hospital, freeing up beds and reducing some of the pressures on the ambulance service and local emergency departments.
Paynter said: “The obviously ill patients are relatively easy to manage, these receive prompt intervention and referral to the appropriate facility; more challenging are those patients with subtle signs and symptoms. This is where Broomwell’s expert service is of most benefit. The ultimate clinical responsibility rests with the nurse practitioner managing the patient. All staff are acutely aware that a normal ECG does not exclude a developing myocardial event, and as such all chest pains and collapses are treated cautiously.”
The hospital secured investment after negotiating with Somerset Primary Care Trust to keep the system and Paynter says he would recommend it to anyone interested in help with dealing with 12-lead ECG readings.
“A large number of GPs within the area have expressed an interest in joining the service; they see it as an integral part of modern healthcare provision. I would like to see this type of service rolled out to all minor injury and urgent treatment centres across the country – it brings emergency department standards of diagnostic support into the community.”
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