{
  "abstract": "Background Heart failure (HF) carries high morbidity and mortality, but early diagnosis in primary care is often delayed due to gaps in natriuretic peptide testing and access to echocardiography. NICE guidelines (NG106, QS9) and the NHS Long Term Plan emphasise rapid community-based HF diagnosis. This project aimed to address these delays in a real-world general practice setting, supporting BACPR standards for early detection, timely treatment initiation, and enhanced patient experience.Aim To increase same-day NT-proBNP testing rates and improve echocardiography referral for patients with NT-proBNP ≥400 pg/mL, in line with NICE and BACPR standards.Methods Over six months in an urban general practice, we audited every ‘ECG requested’ consultation for HF symptoms (n=23). NT-proBNP orders were categorised as same-day, within 30 days, or not requested. Echocardiography referrals were tracked for those with NT-proBNP ≥400 pg/mL. Two PDSA cycles were implemented: (1) clinician education on NICE NT-proBNP thresholds; (2) a secretarial verification step ensuring no echocardiography referral proceeded without a recorded NT-proBNP result.Results Same-day NT-proBNP testing increased from 22.2% (2/9) at baseline to 75.0% (6/8) after both interventions. Testing within 30 days declined from 22.2% to 12.5%, and cases without NT-proBNP requests fell from 55.6% to 12.5%. Echocardiography referral compliance remained at 100% throughout. A chi-squared test showed a positive trend toward improvement (χ² = 4.74, p = 0.093).Conclusion Embedding NICE-aligned education and a simple administrative check produced rapid, low-cost improvements to HF diagnostic pathways. This model aligns with BACPR standards by promoting early, community-based diagnosis, improving access to lifesaving therapies, and enhancing patient experience. It offers a scalable blueprint for wider adoption across primary care networks.",
  "authors": [
    {
      "affiliations": [
        "Royal Bolton Hospital, Minerva Rd, Bolton, BL4 0JR, UK"
      ],
      "name": "Sohail Daniel"
    },
    {
      "affiliations": [
        "Westleigh Medical Practise, Westleigh Ln, Leigh, WN7 5JE, UK"
      ],
      "name": "Emma White"
    },
    {
      "affiliations": [
        "Westleigh Medical Practise, Westleigh Ln, Leigh, WN7 5JE, UK"
      ],
      "name": "Michael Florin"
    }
  ],
  "title": "P11 Streamlining the heart failure referral pathway in primary care: a PDSA-driven quality improvement project",
  "uid": "5c9b74b5-9f04-5bcb-86ba-17860c5a39bb"
}