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Opinions of general and adult congenital heart disease cardiologists on care for adults with congenital heart disease in Belgium: a qualitative study

Published online by Cambridge University Press:  06 September 2019

Ruben Willems Open the ORCID record for Ruben Willems [Opens in a new window] ,
Michèle de Hosson ,
Julie De Backer  and
Lieven Annemans
Ruben Willems*
Affiliation:
Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
Michèle de Hosson
Affiliation:
Department of Adult Congenital Cardiology, Ghent University Hospital, Ghent, Belgium
Julie De Backer
Affiliation:
Department of Adult Congenital Cardiology, Ghent University Hospital, Ghent, Belgium Department of Cardiogenetics, Ghent University Hospital, Ghent, Belgium
Lieven Annemans
Affiliation:
Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
*
Author for correspondence: R. Willems, MSc, Corneel Heymanslaan 10, Entrance 42, Floor 4, 9000 Ghent, Belgium. Tel: 3293328332; fax: +329 332 49 94; E-mail: [email protected]
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Abstract

Background:

The growing adult congenital heart disease (CHD) population requires efficient healthcare organisation. It has been suggested that clinically appropriate care be provided for individual patients on the least complex level possible, in order to alleviate saturation of special care programmes.

Methods:

Semi-structured interviews with 10 general and 10 adult CHD cardiologists were conducted to elucidate opinions on healthcare organisation in Belgium. A particular focus was placed on the potential role of general cardiologists. The software program NVivo 12 facilitated thematic analysis.

Results:

A discrepancy existed between how general cardiologists thought about congenital care and what adult CHD cardiologists considered the minimum knowledge required to adequately treat patients. Qualitative data were categorised under the following themes: knowledge dissemination, certification, (de)centralisation of care, the role of adult CHD cardiologists, the role of dedicated nurse specialists, and patient referral. It appeared to be pivotal to organise care in such a way that providing basic care locally does not impede the generation of sufficient patient volume, and to continue improving communications between different care levels when there is no referral back. Moreover, practical knowledge is best disseminated locally. Cardiologists’ opinions on certification and on the role of dedicated nurse specialists were mixed.

Conclusion:

On the basis of the results, we propose five recommendations for improving the provision of care to adults with CHD. A multidimensional approach to defining the role of different healthcare professionals, to improving communication channels, and to effectively sensitising healthcare professionals is needed to improve the organisation of care.

Keywords

Adult congenital heart diseasegeneral cardiologisthealthcare organisationcertificationcommunicationdedicated nurse specialist
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 11 , November 2019 , pp. 1368 - 1374
Copyright
© Cambridge University Press 2019 

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