6817 The impact of telephone consultations in triaging babies with a family history of heart disease

Objectives A number of babies are referred to clinics conducted by paediatricians with expertise in cardiology (PEC) because of a family history of heart disease.¹ We compare two cohort studies looking at these referrals following the implementation of new referral guidelines, education packages for all staff conducting NIPE and the impact of telephone consultations on triaged referrals. Methods We conducted a retrospective study by gathering data from electronic medical records. The 2 study periods were: September 2019 to February 2020 and September 2022 to February 2023. We compared the number of face-to-face (F2F) and telephone consultations (TC) in the two cohorts. Results A comparison of 2 cohorts is shown in table 1. Referrals originated from various sources, including the post-natal ward (51%), NICU (16%), transitional care (14%), the delivery unit (7%), and the midwifery-led unit (10%). Most of these patients (78%) were referred by neonatal doctors. Among those with a family history, nearly half (38 out of 77) underwent telephone consultations, with the majority being discharged (27 out of 38). Fewer patients were referred over six months (149 compared to 167). The median waiting time was decreased (59 days compared to 66 days). Conclusion Telephone consultations have proven to be a safe and efficient method for safely reducing the number of infants requiring F2F clinic review. This was achieved when the family history was not clearly identified in the original referral; the first-degree relative did not require any intervention, and concerns in more distant relatives were not valid. This intervention reduces the number of unnecessary clinics and travel for families. It also frees up clinic space for other F2F consultations. A small number of face-to-face appointments were required following a TC; these appointments were scheduled more appropriately. The new guidelines, education packages and reduced number of babies seen inappropriately in the clinic have allowed better utilisation of clinic capacity. Reference Øyen N, Poulsen G, Boyd HA, Wohlfahrt J, Jensen PK, Melbye M. Recurrence of Congenital Heart Defects in Families. Circulation 2009;120(4):295. Epub 2009 Jul 13.