Tuesday 14th July 2020
In 2018 we released Our Gold Standard of Care - Best Practice in the Diagnosis, Treatment and Management of Heart Valve Disease. Our Gold Standard brought together leading clinicians from across the treatment pathway, as well as a group of heart valve disease patients, to identify what best practice in heart valve disease care looks like. This gold standard is set out in a series of Quality Statements and Recommendations which cover the treatment pathway in its entirety.
Last week, our CEO, Wil Woan, spoke to President of British Cardiovascular Society, Professor Simon Ray, about how COVID-19 had changed the shape of in-person communication in the patient pathway. The two main areas they looked at were Digital Appointments and Virtual MDTs.
As we move forward in our COVID-19 response, how Gold Standard of Care will be crucial to ensuring new practices are patient centred. Communication formed a central part of our Gold Standard and these new virtual clinics and consultations advance some of our recommendations. However, as these practices develop patient input will be crucial in maintaining optimal patient experience.
In our Gold Standard, our quality statement on Communication stated:
“Patients should have a clear understanding of their disease and the reason that treatment/no treatment has been prescribed at the earliest point on their pathway. This holistic understanding should include: the timing of surveillance; guidance on medication, dental care and general cardiovascular fitness; individual advice on the feasibility of exercise – based on their specific condition and their favoured activities; advice on the safety of sexual activity; as well as knowledge of potential triggers to treatment, red flag symptoms and palliative care, where appropriate. Information should be provided via a range of sources, including face-to-face communication and telephone consultation, as well as through written and online materials.”
As we move forward, we understand that face-to-face communication will become more limited. So, within this new normal, an expectation has to be put in place for patients. Heart Valve Voice will consult with patients who are awaiting treatment for heart valve disease, and have had their services transferred to a digital service, and clinicians who are running virtual clinics to set this expectation. Once an expectation is agreed upon, it will be included in our resources for patients on virtual clinics.
In addition to this, in the coming days we will release a Digital Appointment Guide. This new resource will provide patients with advice on how best to prepare for digital appointments, and aims to foster the same comfort and confidence patients get from in-person services.
In our Gold Standard, we also set out some specific recommendations for MDT’s. This new virtual MDT is a step in the right direction, and this more nimble approach will allow for faster decision making with more input from external services. The key recommendations for MDT’s in our Gold Standard were:
- All MDTs should be made up of the following core team of healthcare professionals: an interventional cardiologist with a specialist interest in TAVI, a cardiac surgeon with a specialist interest in TAVI and SAVR, an imaging cardiologist who specialises in echo and CT, a general cardiologist, and a clinical nurse practitioner. Dependent on the needs of the individual patient, an MDT should also have access to a wider team, including: a care of the elderly physician, a vascular surgeon, a vascular radiologist, a cardiac anaesthetist, and palliative care clinician.
- Where possible, discussions held within MDTs should be captured and this decision making process should be communicated clearly with the respective patient to ensure they understand the reasons behind their treatment decision.
This new form of MDT’s increases access, a central part of our recommendations. This improved access to MDT’s will streamline patient pathways and improve decision making. However, with this new approach, access can also broaden out, and now new sectors can be involved in key decision making. In addition to this, the virtual style lends itself better to being captured, and improve communication with the patient to ensure they understand.
“Ultimately, communication is going to be central to this digital innovation in clinics, consultations and MDT’s. Patients need to understand why this is the new way of doing things, which I’m sure they do, but they also need to understand what to expect from this new style of service. In addition to this, patients and clinicians need to work together to improve their digital relationships, to promote comfort and confidence in this system. We’ll be working hard to find out what practice meets everyones needs and will communicate that very soon." Wil Woan Heart Valve Voice CEO