Mapping Greener HealthcareMapping Greener Healthcare

Goal: To plan the introduction of new LINQ heart rhythm monitors that can be fitted away from the pacing lab by a physiologist rather than a consultant.

Background: Currently, implantable loop recorders (ILRs) are offered - requiring specialist equipment in the form of heart rhythm monitors and the specialist skills of a consultant to implant. Using new LINQ devices would not only free up the lab for other procedures but brings benefits to patients in the form of less follow up appointments.

Approach:

  The project will require:

1. Team-work of the consultant cardiologists, heart centre manager and at least 2 senior cardiac physiologists.
2. Guidance from the device company
3. Guidance from infection control, to help establish a ‘clean room’.
4. A clinic room
5. The Medtronic programmer owned by the unit will need to be made available.

Savings: Approximately six ILRs are carried out on the unit each week. The following potential savings have been identified:

• No follow up appoints, saving patient time and money and reducing emissions from transport and NHS carbon from the outpatient appointment itself (56 KgCO2e).
• ILR patients may wait a 7-10 days waiting for a pacemaker. Moving to LINQ will free consultant time to perform more complex cases and may reduce patient emissions (446 kgCO2e per inpatient admission).
• A radical reduction in the length of day patient visits, shrinking energy demands per intervention and increasing throughput.
• Less equipment and clinical waste.
• Reductions in sedation (95p per patient and approx. 0.42 kg of CO2).
• Reduction in nursing staff time at £32 and 5kg CO2e per procedure.
• Reduction of consultant time of £137 per hour and approximately 16.44 kgCO2e

Much of the data needed to calculate savings has not been made available. However from the known costs, each LINQ insertion procedure will save at least 78kg CO2e and £170. Assuming 6 conventional ILRs are substituted by LINQs insertions and that an hour of nursing and consultant time is saved per procedure (these may be vast underestimates) the known annual savings are 23.3 tonnes CO2e and £50,985. This does not include the substantial environmental, financial and social savings realizable from shorter hospital visits and reductions in bed days.