University of Worcester Worcester Research and Publications

Evaluating the congenital heart assessment tool: a quality improvement project

Smith, L., Wray, J. and Gaskin, Kerry ORCID: (2022) Evaluating the congenital heart assessment tool: a quality improvement project. Cardiology in the Young. pp. 1-8. ISSN Print 1047-9511 Online 1467-1107

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An early warning tool, the Congenital Heart Assessment Tool (CHAT), was designed in 2012 to support parental preparation before discharge, enhancing understanding of their infant’s complex CHD, the signs of deterioration to look out for and to support decision-making at home. Acceptability and feasibility of the tool were tested during 2013–2015 in a single centre.

Aim of this project:
To evaluate the wider implementation across four children’s cardiac centres of the CHAT for infants with complex CHD in the community setting.

A four-centre collaborative mixed-methods quality improvement project funded by The Health Foundation, during 2016–2018. A plan, do, study, act cycle of improvement was employed. This article reports on the planning phases, creation of a modified tool (CHATm); and the implementation phases, including retrospective case note review using CHATm; tabletop simulation exercise using CHATm and clinical implementation of CHATm.

Key findings included the benefit of using CHATm simulation for practitioners; the effectiveness of CHATm in predicting amber and red triggers, indicating parental actions and escalation of concerns to professionals. Parents using CHATm found it enhanced knowledge in preparation for going home, supported decision-making, and discussions with health care professionals.

Using the CHATm clinically identified the need to develop a structured model of assessment of parental suitability for home-monitoring programmes. A robust and nationally agreed training programme for all staff using CHATm was recommended to ensure successful and complete implementation in practice.

Item Type: Article
Additional Information:

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

Uncontrolled Discrete Keywords: Infant, caregivers, patient discharge, quality improvement, heart defects, congenital, decision-making
Divisions: College of Health, Life and Environmental Sciences > School of Nursing and Midwifery
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Copyright Info: © The Author(s), 2022. Published by Cambridge University Press
Depositing User: Kerry Gaskin
Date Deposited: 22 Jun 2022 12:40
Last Modified: 22 Jun 2022 12:40

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