Educating healthcare professionals to improve the treatment of iron deficiency
The Royal Brompton Hospital, a heart and lung specialist centre in the UK, developed an awareness campaign targeted at the heart failure (HF) care team to improve management of iron deficiency in HF.
The campaign was launched after it was discovered that people with symptomatic HF with reserved ejection fraction (HFrEF) managed in the hospital were not being systematically screened and treated for iron deficiency. It included the use of reminders during multidisciplinary team meetings, email notifications and stickers on clinic notes.
These interventions succeeded in increasing the number of people with HF tested for iron deficiency from 50% to 100%, but this effect was not sustained over time. Treatment rates did not increase, and organisational barriers were identified as a potential cause for this – notably, admission was shown to take a median of seven hours, whereas the actual medical administration time was only 15–30 minutes.
As part of this study, the HF care team assessed the feasibility of treating ion deficiency in an outpatient setting, based on a single patient. The visit lasted 75 minutes (including treatment administration and monitoring) and was found to be cost-saving.
Hayward C, Patel H, Allen C, et al. 2016. Improving the management of iron deficiency in ambulatory heart failure patients. BMJ Qual Improv Rep 5(1): 10.1136/bmjquality.u209822.w4076