P196 Evaluation of local cardiology services for infants and neonates with suspected congenital heart disease

Background Murmur is one of the commonest reasons for referral to paediatric cardiologists. This has caused a long waiting time for clinic and increased parental anxiety. Objectives To assess the local cardiology services for suspected congenital heart diseases in neonates and infants at Princess Alexandra Hospital Harlow, Essex, UK Methods Retrospective data was collected from period of May 2018 to November 2018 from online database and patient notes including all the neonates and infants referred and seen in paediatric cardiology clinic during this period. Results Total 30 patients were studied. 56.6% were females and 43.3% were males. The mean waiting time was 4 months. Commonest reason for referral was heart murmur in 40% patients and 2nd common reason was family history of congenital heart diseases in 30%. Echocardiogram was normal in 20% and the commonest defects were VSD and ASD 20% each. Amongst those having heart murmurs 16.6% were normal and discharged, 8.3% had PFO and discharged and 8.3% had tiny PDA. Our local referral pathways recommend discussion with consultant before referral but only 10% patients were discussed with the consultant and 83.3% had no documentation regarding discussion with consultant. In only 105 of referrals the local referral pathway was followed. Conclusion The commonest reason for referral to cardiology clinic for infants and neonates is heart murmur. If we develop our local murmur guidelines then it will be easy to decide whom we need to see in cardiology clinic and this can avoid un-necessary cardiology clinic referrals without missing the pathologies. We intend to develop our local murmur guidelines as a next step to quality improvement project. Recommendations Create awareness amongst doctors about cardiology clinic referral form for neonates and infants with suspected congenital heart disease through teaching sessions and during induction of new doctors. The referral form should be duly signed by the consultant making referral and the cardiology consultant accepting and the signed form should be attached in the patient notes in correspondence. We need to develop out local cardiology guidelines for neonates and infants with heart murmur and/or suspected congenital heart disease so that un-necessary referrals can be avoided without missing the congenital heart defects.