Developing the best fetal cardiology unit I can

(32 Posts)
KBee1 Thu 04-Feb-16 10:27:23

Hi there - I'm a fetal cardiology specialist with a lump of charity money to spend on enhancing our department - what kind of things would YOU guys like if you came for a fetal cardiolgy scan. Could you please tell me about everything from information/posters to equipment etc. Thanks!

lljkk Thu 04-Feb-16 10:28:06

Message deleted by MNHQ. Here's a link to our Talk Guidelines.

OhShutUpThomas Thu 04-Feb-16 10:29:38

Nice lljkk!

I haven't any experience of this OP, but hopefully someone who has will be along soon.

Micah Thu 04-Feb-16 10:34:59

Really?

Are you in the US? Private medicine?

Because I really can't see a Paediatric Cardiology Specialist having time to even worry about posters and leaflets, let alone trawl mumsnet for opinions. Plus surely you're the one who knows what equipment you should need?

I think you should get the machine that goes beep, version 33.67 is better then the new one.

hmm

OTheHugeManatee Thu 04-Feb-16 10:36:31

If it's NHS, then chairs for the waiting area that aren't torture to sit in for the 90 minutes you usually have to wait. Sofas, ideally. Comfortable ones grin

KBee1 Thu 04-Feb-16 10:36:46

Wow, aggressive. You're a real hero. The idea is to get opinions from people who might use the service.

steppemum Thu 04-Feb-16 10:39:26

We attended a foetal cardiology unit when I was pregnant with dd2.

The ONLY thing I was interested in was

1. the best, most expert care from the best doctors with plenty of experience so they knew what they were looking at.
2. the most up to date equipment to see what was going on.

As my case was atypical leaflets would have been useless.

Fortunately all of this was provided free of charge by one of the best doctors in the country by the NHS

KBee1 Thu 04-Feb-16 10:39:30

Nope. I'm in the UK. And I make time to research opinion from all sorts of sources because it's important to me. I don't want to waste people's generous donations on things that won't help.

You'll be please to know we already have very comfy armchair style (but easy-wipe!) chairs in our department.

KBee1 Thu 04-Feb-16 10:41:51

Ok, so steppemum - would sending staff to certain courses (see link) qualify as a good use of the money in your opinion? www.arc-uk.org/for-professionals/training-and-events

strawberrypenguin Thu 04-Feb-16 10:43:31

I'd want the best equipment possible and to be talked through exactly what was happening and what was being looked at and why. To be honest I wouldn't be looking at posters etc

crumblybiscuits Thu 04-Feb-16 10:45:19

*The ONLY thing I was interested in was
1. the best, most expert care from the best doctors with plenty of experience so they knew what they were looking at.
2. the most up to date equipment to see what was going on.*

Seconding this. If you have these things already then posters really don't mean anything to me. I would also assume that all staff would have already undertaken courses in those veins but I would assume that should be standard for someone working in antenatal testing already.

steppemum Thu 04-Feb-16 10:45:43

well, as I am not medical, or have any idea about it, then I wouldn't know if these courses would help. That has to be a medical decision surely?

I just want to know that the person looking at my scan really knows what he/she is talking about.

we were pre- 3D scans. I think my dds case would have really benefited from a 3D scan as no-one knew what they were looking at. (first time they had seen it) and it was hard to see with normal scan.

So if that isn't routine, then get a 3D scanner.

crumblybiscuits Thu 04-Feb-16 10:46:28

Also making sure people are actually around to answer the phone ect. Our fetal medicine unit is three hours away and sometimes we couldn't get through on the phone for hours and hours to get results and things.

Micah Thu 04-Feb-16 10:46:31

Are you a Dr or a ward manager then?

Staff are always being sent on courses. CPD is heavily supported in the NHS. It's entirely normal and I don't see why you need to ask patients and the public if you need to.

Charity money is always, in my experience, applied for in the form of a grant, and you need to write your proposal with a breakdown of what you will use the money for before you get the money. They're fairly narrow too- you might get a grant for staff training, or a new machine, or flowers for the office, but I've never heard of a charity just giving a load of money to spend on whatever you please. The Charity is accountable, as much as the person receiving the money.

Are you involved in ARC by any chance?

SandunesAndRainclouds Thu 04-Feb-16 10:49:51

I didn't need foetal cardiology (fortunately!) but I did have various scans to exclude other anomalies.

I agree with the above re: staff knowledge and competency but I would add counselling services who were equally knowledgeable. I was given incorrect information from a well-meaning but sadly misinformed midwife which equated to several weeks of heartbreaking worry which was unnecessary. Providing a service to follow up from scans, to continue care and information would've been brilliant for me.

lljkk Thu 04-Feb-16 10:51:01

You are also using the hospital's established formal patient consultation channels, yes??

Setting up open-ended questions on SurveyMonkey would be appropriate, it's free as long as you have less than 100 replies.

When I had many extra scans for enlarged renal pelvis, I would have liked hard statistics about the likelihood of different outcomes for my baby. Soft chairs or pretty posters, I could not have cared less about. A play area for people who have to bring other children along would be good, but I think the trend now is to have very few toys incase they transmit disease sad

slebmum1 Thu 04-Feb-16 10:55:56

Expert care and expert equipment that's all I wanted.

ohanami Thu 04-Feb-16 11:31:34

Wow, I can't believe the op is getting so much stick for asking for advice! Presumably you've all waited at least once in a grim nhs waiting room with tatty, out of date leaflets on the scuffed walls, no information about what's going on if there's a delay, uncomfortable chairs that sit you crotch to crotch with strangers... It takes minimal effort to make a waiting area comfortable and relaxed but as clinicians who see it just from a clinical perspective it's hard sometimes to guess what would make it better, so it's good practice to ask people who might use a service what they think.

Anyhow, rant over, the opposite of all of the above would almost certainly go down well. Is all the information on your walls up to date and relevant? Have you got clear signpost about who to speak to if there's a delay, and can the receptionist handle people's queries professionally and accurately if there's a delay for example. That's maybe not so much about the money you've got as it is about giving staff a couple of hours to learn about what makes great customer service. Maybe think as well about setting out the seating differently so it feels less formal, like a coffee shop layout rather than rows of seats. I don't know if it would be helpful for antenatal patients, but we spent a few weeks in nicu with dd and it was really nice to read case studies on the walls about what happened to patients after they had their treatment - positive stories that showed the tiny babies growing into healthy toddlers (though I appreciate not everyone would want to see that).

I'd take for granted up to date equipment as I'd assume a fetal cardiology centre is quite specialist and well equipped to start off with. But if there's anything you're aware of that you don't have, I'd be reassured as a patient to know that you've got the best kit to treat me with.

Oh - and as many of your patients are likely to already have a child that they might have to bring with them, something to make a family friendly environment, toys to play with if that's not an infection control risk, no images on the wall (eg prominent information leaflets?) that could be too confusing or scary. Or a couple of small chairs? If you've got a patient engagement or experience team at your trust I'm sure they'd be able to give some more specific advice about speaking to some of your existing patients.

Good luck - I hope you find some ways to make the department a more comfortable place for potentially stressed or worried parents to be. I think it's great that you're reaching out for ideas and opinions, thank you.

crumblybiscuits Thu 04-Feb-16 11:42:33

Oh - and as many of your patients are likely to already have a child that they might have to bring with them, something to make a family friendly environment

I would say the opposite of this to be honest. There will be lots of people coming to discuss their unborn baby's death/illness. I really disliked people bringing their other children to the fetal medicine unit and I wouldn't want to sit amongst toys and family environment things while being given the news that I wouldn't take my baby home. I would much rather a formal but comfortable and private clinical setting.

Micah Thu 04-Feb-16 11:42:56

I think it's great that you're reaching out for ideas and opinions, thank you

As lljkk has already said, hospitals have many ways of reaching out for ideas and opinions. There's survey monkey, as mentioned, many hospital boards, panels and committees, and it's a fairly regular occurrence to hand out questionnaires to actual service users to fill in after their appointment on how things can be improved.

MN, despite being opinionated, really wouldn't have much of a clue compared to the patients actually using the service.

It's not unusual for a student Dr, nurse, or work experience person to be given this type of project. I have been involved in many grant applications, spending charity money, and consulting service users, and not once has anyone ever said "hang on, we'll ask mumsnet".

RedKites Thu 04-Feb-16 11:44:10

A good leaflet with information about what you do, and odds of there being a problem, etc. sent out to all the local hospitals that might refer to you. I think it was fetal cardiology that I saw when I was pg with DS2. The people I saw at the centre were great (although echo comments about waiting rooms!). However, the sonographer at my local hospital who referred me was awful. She said there might be a problem with my baby's heart but that there 'probably' wasn't which left me distressed and worried. Some proper information, and maybe even a phone number I could have called, would have been significantly better.

Ethelswith Thu 04-Feb-16 12:03:49

I'm unlikely to be using the maternity services again, but having needed detailed scans in one PG (and then having them for all subsequent PGs) I'd like to comment.

Unles you have unusually good staff retention, I wouldn't use a lump sum to fund CPD. Not because it isn't important, but because staff move on. Funding a specialist counsellor post might be worth it.

I'd assume that the doctors would be the ones to decide on which machines and how many of them, so nothing to add on that.

What makes a real difference is a good waiting area, ideally free of babies and small children (just heartbreaking to be near). If it can somehow be subdivided so there is a modicum of privacy, all the better. Obviously in good nick, comfortable, and perhaps with a free drinks machine. I'm not bothered about information leaflets - by the time you've reached that stage, you may well be looking at something quite rare, so producing high quality ones to cover all these possibilities might not be worth it. OTOH, basic fact sheets with reliable internet links for sources of information might be worth it, so that's funding staff time for someone to create and maintain them, for all they need is to be printed off on A4 (perhaps selecting from a database of good links, and things that C&P to suit the patients exact needs).

You also need, I think plenty of small private rooms with comfy furniture so post scan discussions can be in private, and people can stay until the tears dry.

And a good appointments system, with a direct line for all those referred to you. And staff it with people who can pull strings to get the best out of the other maternity services, so that people in shock aren't grappling with other bits of the bureaucracy, being called in for wholly unnecessary appointments (because the regular system doesn't know to pause) or (even worse) being told off for a no-show at an antenatal clinic after a TFMR in the very same hospital.

And invite both ARC and SANDS to comment as well.

glueandstick Thu 04-Feb-16 12:15:20

Kindness and compassion from the staff. Staff that listen, explain and reassure rather than just thrust leaflets and fuss around. Excellent communicators and patient focussed. Calm waiting areas without shed loads of advertising for baby products and somewhere quiet for those not wanting to sit in a large area if they are distressed. Cold available water and decent magazines. Make it calm and cosy but most of all have staff who actually want to be there and are kind.

lougle Thu 04-Feb-16 12:18:56

I think the main question is whether the lump of money is a one-off or a continuing fund.

BlackbirdSingsInTheDeadOfNight Thu 04-Feb-16 12:20:04

Charity money is always, in my experience, applied for in the form of a grant, and you need to write your proposal with a breakdown of what you will use the money for before you get the money. They're fairly narrow too- you might get a grant for staff training, or a new machine, or flowers for the office, but I've never heard of a charity just giving a load of money to spend on whatever you please. The Charity is accountable, as much as the person receiving the money.

Yes Micah you are absolutely correct.

It's very unusual to have a lump of charity money without an already agreed cost list. How can you report back to the charity on measuring outcomes/project success if you haven't already agreed on what you're purchasing? Have you agreed on capital or revenue expenditure?

It's very kind of you to ask our opinions, though, and I hope your project is a success. smile

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