Who's using the Angina Plan?

Jenny Rumsby: The Angina Plan in the Cardiology Day Ward

Patients on the Cardiology day ward receive the results of their angiograms before discharge, and it was apparent that these patients could benefit from further information relating to their CHD and support in how to manage their condition and improve overall fitness. Although the Angina Plan met these needs, the pilot studies were carried out in primary care environments, so implementation within a secondary care setting was both innovative and challenging. As the staff were looking at a different way of implementing care it was vital that we supported each other whilst we gained confidence. Patients were offered the Angina Plan once they were out of bed, and interviewed before discharge if they accepted. Subsequent follow up phone calls were then made at the patients convenience. We informed the patients GPs if the patient took up the Plan, to raise awareness, and the practice nurse when it was completed, so the patient would be included in annual CHD clinics.

Because our patients come from a very large catchment area (being a tertiary centre), it would have been impractical to try and take on every suitable patient. Therefore we referred patients back to their District General hospitals to be followed up by Angina Plan facilitators from these areas. This was very successful in providing a more equitable service, but also enabled us to form networking links with other professionals.

Patients that completed the Angina Plan through the Cardiology Day Ward, were sent a Likert style questionnaire to evaluate its effectiveness. We had very positive responses from the patients with some encouraging feedback, particularly from those patients who were waiting for CABG surgery, and considered the implementation a success.

As a result I developed a facilitators support group for clinical supervision and to share best practice, and worked with our IT department to build a data base to store and track patients on the Angina Plan.

For me this was a steep learning curve, but I haven't looked back since. My knowledge base has increased, and I now feel more confident in identifying new ways of developing patient care.

Reproduced from BACR Newsletter 2004;4(3):7-9)

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