Illustrating: The use of Helicon Heart for Clinical Governance; Patient outcome measures; Quality Control of equipment; Patient satisfaction

The Clinical Commissioning Group

The health commissioners of Romire are responsible for 260,000 people. They have invested in the development of shared care atrial fibrillation and stroke prevention services. These shared care service have been planned on the basis that approximately 80% of the patients with atrial fibrillation or needing anticoagulation could be well managed in the community environment in community pharmacies or in GP Practices. Eight community sites were designated and the staff trained to deliver high quality services.  The goal is to reduce the likelihood of developing strokes or heart problems due to the atrial fibrillation. The commissioners had also seen the benefits derived by other commissioners who have implemented HeliconHeart’s Anticoagulant and Stroke Prevention services.

The Clinical Governance

The commissioners need to be able to show evidence of a high quality service wherever it is being delivered. They also need to be able to measure patient outcomes, analyse the data and monitor patient satisfaction.

Setting up HeliconHeart 

  • The Helicon Health team worked closely with the commissioners to define the patient referral pathways
  • The team worked to ensure that:  a safe and modern browser was installed on the PCs in the GP Practices; the HeliconHeart icon was installed which enables direct access to the log-on screen of the secure Helicon Health server; arrange the secure access via the NHS network to the server.
  • The education and training course for the anticoagulant and stroke prevention practitioners (GPs, nurses, pharmacists) was delivered. This includes a clinical examination to test both knowledge as well as clinical skills and ensures that everyone involved in the service is conversant with the use of HeliconHeart and the associated near-patient testing devices.

How Helicon Heart helps 

  • HeliconHeart enables  real-time audit for the clinician or for the commissioner.   In this instance the commissioner will only see anonymised patient data; individual patient identifiable data will not be visible to them.
  • The quality measures of performance and outcome on the different sites can be seen and compared.
  • The commissioner can see the quality assessment (QA) results of the near-patient-testing equipment. Satisfactory internal and external QA measures relating to the equipment ensure that the results obtained from finger prick blood tests can be relied upon.
  • HeliconHeart enables sites to show the degree of satisfaction that the patient has experienced with the services provided. These results will often be discussed at the Clinical Governance Board as well as by the commissioners

COMMUNITY BASED ANTICOAGULANT AND STROKE PREVENTION SERVICES  IN ROMIRE
Anticoagulant control in time period  01.01.2012 – 31.12.2012
NPSA measures

BOROUGHSite (year commenced)Patient
Number (New plan)
Visits% INRs within range%time in range
(fraction of INRs)
% of INRs <1.2% of
INRs >5
% of
INRs >8
ROMIREGP Practice 1 (2011)115 (78)75365651.50.50
GP Practice 2 (2012)14 (14)816767000
Community Pharmacy 1 (2012)340 (20)310062623.01.20.2
Community Pharmacy 2 (2012)198 (15)1809676701.62.0
Health Centre 1 (2011)166 (55)1577707001.01.0
Health Centre 2 (2009)120 (10)119063631.00.81.4
Patient self-testing35 (3)3507272000
Community Hospital (2009)302 (21)150069691.00.40.4
District General Hospital (1987)870 (45)875055550.81.31.2

Anticoagulant & Stroke Prevention Clinical Governance
INTERNAL AND EXTERNAL Quality Assessment –  Quarter 4

Quality Control - copies of logs to be sent with this formClinic 1Clinic 2Clinic 3Clinic 4Clinic 5Clinic 6
Quarterly NEQAS results (External QC)
Internal Quality Control results
Number of Machines passed Internal QC
Number of Machines failed Internal QC
Fridge Temperature (MIN-MAX Degree Celsius)
Room Temperature (MIN-MAX Degree Celsius)