Amanda Crundall-Goode’s first month as Lead Heart Failure Nurse Specialist at Oberoi Consulting

Amanda Goode

Amanda Crundall-Goode – BSc (Hons), DipHe RN, INP, FESC, Post Grad Heart Failure

I joined the team this month, what can I say!

The Oberoi team are friendly, dynamic and a formidable team.

As an experienced advanced nurse practitioner, working with patients with heart failure (HF) for over 20 years, I have had experience in not only direct clinical care and management but also audit and research.

My previous experiences of conducting HF audits in primary care have just been top-trumped by having the opportunity to use the Oberoi system.

Clinical searches are deployed within the practice’s clinical system (e.g. SystmOne, EMIS) which automatically runs an update every 3 months.

After using other audit tools, which have been complicated to use, the Oberoi method couldn’t be easier as everything sits within the clinical system.

The searches are compiled into an easy-to-read professional report for the lead healthcare professional to peruse.

The report categorises the patients into type of heart failure and whether they are taking any of the four pillars of contemporary heart failure management (i.e. ARNI/ACEi, Beta-blockers, MRA and SGLT2i therapies).

These searches are in addition to providing the clinician with a heart failure disease register and case finding data.

As a nurse this has shown to be not only efficient, easy to navigate, comprehensive but totally patient focused.

From the report I was able to access corresponding searches on the clinical system.

For example, patient A had heart failure due to left ventricular systolic dysfunction (or now known as HF with a reduced ejection fraction (HFrEF)) and was identified as taking only two (ARNI and BB) of the four pillars of heart failure management.

Patient A notes were reviewed and an appointment made for a virtual clinic, so that other evidence-based therapies could be considered and initiated.

Patient B was not identified as taking ANY medications for HFrEF, after notes review it was noticed that prescriptions had not been requested by the patient. This prompted a clinical review of the patient.

To facilitate the patient review there is a HF notes review proforma that allows the nurse or other health professional to write recommendations which is then saved within the patient’s record. Using the proforma is simple and clear.

Within the clinical system there are alerts which are present once the patient record is open.

For those professionals who are not as familiar with HF management these alerts highlight what is potentially missing from the patient’s medication plan and serve as an important reminder.

The system is intuitive, saving time for me as a busy heart failure nurse whilst triaging patients for priority review in primary care.

If you would like to hear more about the ODM HF audit platform and clinical review service please do not hesitate to contact me on Amanda.goode@oberoi-consulting.com

Further information on the four pillars of heart failure management can be found at: https://openheart.bmj.com/content/8/1/e001585