A bottom-up multidisciplinary approach to improve paediatric cardiology care
in Sweden
Jan Bergils, Malin Linder, Anette Leion, Katarina Hanséus
Background:
Paediatric cardiac surgery in Sweden is concentrated at two centres (paediatric
cardiology is practised in about 30 hospitals), and the results of surgery regarding
survival are excellent with a mortality rate of <2%. In order to promote survival and
good quality of life, collaboration between all levels of care is mandatory, however
distances, diagnostic ability and accuracy, follow-up and resource use varies greatly
within the country. Every third year, a multi-professional (including representatives
from the parents’ association) meeting is held, with the aim to improve
communications and cooperation in different levels of care. At the 4th meeting in 2011
a new approach was tried in order to promote national collaboration, inter-disciplinary
work and evidence based care.
Methods:
Four areas of concern were defined; follow-up, communication, education and
incoming referrals. Locally used guidelines, healthcare programs and “tips&tricks”
were presented at a public webpage.
About 150 persons (of approximately 300 possible), mainly physicians and nurses,
but also medical secretaries, biomedical laboratory scientists, physiotherapists,
dieticians, occupational therapists, psychologists and social workers attended this
three-day meeting.
The congress’ main part consisted of multi-professional workshops, with the objective
to share and develop material and improvement ideas. The workshops were led by
professional facilitators, and the results were further discussed in a plenary session,
and plans of actions were created.
Results:
Thirty specific topics were defined, called “heroic deeds” and for every topic a leader
with responsibility for the continuing progress was defined. Seven new professional
networks were also created.
Conclusion:
With a bottom-up approach, involving different professions nationwide, it is possible
to create a foundation for national guidelines and standardized care, which has the
potential to make better use of resources and increase the quality of care for children
with heart disease.