Belfast Hospital pioneers care in the home for young heart patients

5 April 2006

Through its Home Care project, the Paediatric Cardiology Department at The Clark Clinic of the Belfast Children's Hospital has been piloting the use of videoconferencing to provide care-in-the-home for babies and very small children recovering from heart surgery. In its operational phase the project has proved the benefits from using  these systems have been much larger than first expected and hoped for by all involved. Its success has led to the hospital preparing a Business Case for including the project as part of its everyday clinical care for children.

The Clark Clinic is responsible for paediatric cardiology for the whole of Northern Ireland and, to avoid stretching their facilities, prefer patients to return home as soon as it is safe to do so. At the same time they have to monitor their progress and, as the province is essentially a rural area, regular visits to the hospital can prove costly and time-consuming. Through the use of videoconferencing they are in a position to ensure that patients continue to receive high levels of care with their parents in a warm and loving home environment.

Patients are monitored for up to thirteen weeks following surgery. The project is wholly funded and supported by videoconferencing specialists Questmark Limited. A pool of videoconferencing systems is available for installation in each patient's home. The patients and their parents are then able to connect to the Clinic on a needs and scheduled basis via ISDN lines, also provided by Questmark. The systems at the homes connect into to a much larger, more sophisticated system in the hospital's cardiology department. The skills to operate and use the videoconference units to provide care to the children and their parents have been developed in the staff in the hospital. There is no need for any kind of training for the parents as all of the operation of the systems is undertaken by the staff in the hospital.

At set times each day the Clinic's doctors have a videoconference session with each patient. The video quality and signal resolution is high enough for them to determine whether their condition is satisfactory and that they are progressing within their care plan. Conversely should the parents suspect a problem they can contact the hospital for an immediate diagnosis, often avoiding an unnecessary journey.

There are a number of determinants that can alert doctors to potential problems. The colour of babies i.e. the degree of blueness is a significant one; very rapid breathing patterns is another while the hospital also looks at the patients' general demeanour such as their levels of activity, interaction with their parents, and any feeding difficulties.

The major benefit has been the reassurance for parents at a very worrying time that expert advice and care is essentially at the end of a telephone line. In addition, from the experience of the first six months of this project the trial is expected to show tangible economic benefits for the hospital and support will continue to be provided to patients in this way.

“The project has been challenging for Questmark,” says their Chief Executive, Sam McMaster. “Going into the homes of the patients and their parents during very difficult times for them was initially very daunting and a challenge we don’t normally face in deploying videoconferencing systems in other areas. However, in every single case the parents have been welcoming, supportive and very pleased to have had the facility provided to them. The benefits are enormous, as are the thanks we have received from everyone involved. It has been a fantastic and humbling experience for all of our staff involved in this work and it feels great to be having such a positive effect for the parents and staff at the hospital.”

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