Relative communicators: evaluation of an innovative hospital role emerging from the Covid-19 pandemic

Background: During the COVID-19 pandemic, hospital visiting policies made communication challenging. Effective communication is known to reduce anxiety for patients and relatives, and improve trust in healthcare services. We describe an innovative project in which students and staff were deployed to the role of ‘Relative Communicators’, enabling routine updates and facilitating video calls between patients and their next of kin (NOK). The aim of our project was to explore NOK's perceptions of communication about their inpatient relatives and the Relative Communicators. // Method: Participants were asked to complete a structured interview over a telephone call but could use the online form if this was not possible. Hence, we obtained data using a combination of interviews and online surveys. NOK, who utilized the relative communicator service (n = 30), were surveyed. Quantitative data and free-text responses were analysed to understand their perceptions. // Results: 85.7% of respondents (24/28) were satisfied with information they received from Relative Communicators. 43.3% (13/30) of NOK felt they could communicate with their relative ‘the right amount’, and 56.7% (17/30) felt they were sufficiently involved in care decisions. Qualitative data provided further insights around the demand for proactive updates, frustration with existing communication models, and praise of telecommunication methods. // Conclusions: We suggest proactive updates and telecommunication could improve the experience for patients and NOK. Relative Communicators provided a bridge for inpatients and NOK to connect. The pandemic has exacerbated systemic communication issues and innovations, such as the Relative Communicators, may help to address these challenges

South African Dyslipidaemia Guideline Consensus Statement: A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA)

The European Society of Cardiology together with the European Atherosclerosis Society published updated dyslipidaemia guidelines in 2011. SA Heart and the Lipid and Atherosclerosis Society of Southern Africa officially adopt these guidelines. This statement adapts aspects of the guidelines to the South African situation. Using the updated Framingham risk charts, interventional strategies are based according to the cardiovascular risk score and low-density lipoprotein cholesterol (LDL-C) levels. The Framingham risk score refers to the 10-year risk of any cardiovascular event, and includes four categories of risk. Treatment targets are those of the European guidelines. The LDL-C goal is 1.8 mmol/l for the very high-risk group (>30%), 2.5 mmol/l for the high-risk group (15 - 30%), and 3 mmol/l for those below 15% risk. Intensive management of dyslipidaemia in South Africa will significantly reduce the cardiovascular disease health burden

South African dyslipidaemia guideline consensus statement

The European Society of Cardiology together with the European Atherosclerosis Society published updated dyslipidaemia guidelines in 2011. SA Heart and the Lipid and Atherosclerosis Society of Southern Africa officially adopt these guidelines. This statement adapts aspects of the guidelines to the South African situation. Using the updated Framingham risk charts, interventional strategies are based according to the cardiovascular risk score and low-density lipoprotein cholesterol (LDL-C) levels. The Framingham risk score refers to the 10-year risk of any cardiovascular event, and includes four categories of risk. Treatment targets are those of the European guidelines. The LDL-C goal is 1.8mmol/l for the very high-risk group (>30%), 2.5mmol/l for the high-risk group (15 - 30%), and 3mmol/l for those below 15% risk. Intensive management of dyslipidaemia in South Africa will significantly reduce the cardiovascular disease health burden

Transesophageal echocardiography, more than a diagnostic tool: use during surgical ligation of coronary artery fistulae - a case report

Coronary artery fistulae (CAF) are an infrequent coronary abnormality. Herein, we describe the use of intraoperative transesophageal echocardiography (TEE) in the treatment of CAF. A 61 year-old woman presented with chest pain and symptoms consistent with unstable angina. Subsequent coronary angiography revealed the presence of 2 CAF, one extending from the left anterior descending artery to the pulmonary artery (PA) and the other extending from the proximal right coronary artery to the PA. Surgical ligation of the CAF without coronary bypass was arranged. Intraoperative TEE was successfully employed to localize the CAF, monitor fistula blood flow and heart wall motion, and confirm successful ligation. The patient recovered without complications. This case highlights the utility of intraoperative TEE during ligation of CAF