{
  "abstract": "Introduction The Fontan Service Development Project was designed to address significant gaps in the long-term management and follow-up of Fontan patients in South and West Wales. Using a structured Plan–Do–Study–Act (PDSA) approach, the project began with a comprehensive review of existing local and regional services, which identified shortcomings in surveillance, coordination, and continuity of care.Methods To address these gaps, a multidisciplinary team was established, involving paediatric & adult cardiologists, adult congenital heart disease nurse specialists, hepatologists, cardiac physiologists and sonographers. This collaboration enabled comprehensive monitoring of Fontan-related complications, particularly those affecting liver health and overall Fontan physiology. A central achievement of the project was the development of a Digital Fontan Database using crude data collected from Welsh Clinical Portal, Cardiff and Vale Clinical Portal, and Cardiobase which are the three main sources utilized for electronic medical recording in South and West Wales. Creating a digital registry improved follow-up tracking, supported routine clinical care, and enabled concurrent research. The database was iteratively refined based on team feedback to enhance usability and functionality.Service delivery has been optimized by allocating tasks according to individual expertise, improving efficiency and accountability. Standard Operating Procedures (SOPs) and audit frameworks have been developed in alignment with regional practices in Level 1 and Level 2 centres across Southwest England and South Wales, ensuring consistency and continuous quality improvement. The Fontan clinic was formally integrated into the University Hospital of Wales (UHW) schedule, standardizing care across the region.Key developments included the creation of SOP guidelines, standardized clinic letter templates to support surveillance activities, and the submission of a request for a dedicated clinic code to streamline service administration. Close collaboration with paediatric cardiology services supported a structured transition pathway from paediatric to adult care. Additionally, data on anticoagulation use and complications were collected to inform future research and improve long-term patient outcomes.Results Service Audit 2023-2024Count of ‘Follow up Due’ in 2024Total Due Follow up are 24 in number among 129 within a span of 12 months07 in total in 202317 in total in 2024Suspected lost to Follow up: 05Number of deceased patients: 06Conclusion The project aligns with national and international efforts to improve Fontan care. An aim to engage with the UK PrePARE registry, hosted at University Hospital Birmingham, will enable benchmarking against national data and will support evidence-based standardised nationwide service development. Comparative analysis with international Fontan registries further ensured alignment with global best practices.Project was successfully implemented initially in early 2025, with an aim for ongoing refinement through regular audits and feedback as per the structured SOP. A parallel teaching initiative set in place has helped to train relevant staff colleagues in database use and support the development of a liaison service with the Adult Congenital Heart Disease Clinical Nurse Specialist team. Overall, the project reflects to deliver a sustainable, high-quality Fontan service in Wales that integrates clinical excellence with research and continuous improvement.Abstract 109 Figure 1Abstract 109 Figure 2",
  "authors": [
    {
      "affiliations": [
        "University Hopsital of Wales, Cardiff, United Kingdom"
      ],
      "name": "Aisal Khan"
    },
    {
      "affiliations": [
        "University Hopsital of Wales, Cardiff, United Kingdom"
      ],
      "name": "Helen Wallis"
    },
    {
      "affiliations": [
        "University Hopsital of Wales, Cardiff, United Kingdom"
      ],
      "name": "Dirk Wilson"
    },
    {
      "affiliations": [
        "University Hopsital of Wales, Cardiff, United Kingdom"
      ],
      "name": "Navroz Masani"
    }
  ],
  "title": "109 A collaborative fontan service development for South and West Wales",
  "uid": "5ae2b8b7-c629-5777-bfa7-6019a6c0be8e"
}