Emergency Alerts for known Cancer Patients Sara Connor & Mandie Ballentine Colorectal Clinical Nurse Specialist Sandwell and West Birmingham Hospitals Trust

Emergency Alerts…Why ? We often accidentally discovered patients known to us when we were on the wards or a relative phoned When we became aware of the patients after several inpatient days we found Patients under the wrong team Patients who should be brought to the attention of the MDT Patients undergoing unnecessary diagnostics Patients whose needs we could have managed in hours or a couple of days. How could we match our expertise and emotional support on elective pathways for our emergency patients?

Pan Birmingham Cancer Network Working in Partnership with the Network we wanted to identify the typical path of a patient who admitted as an emergency. 20% of all the Emergency Admissions over a two year period were reviewed using patient casenotes and HES data.

Who did the patient see ?

Why were they presenting?

Emergency Admissions Summary Patients admitted as an emergency did not have a journey as well facilitated as our elective patients or those admitted as an emergency with a new primary Admittance into MAU and then Gen Med meant we, the colorectal team, were unlikely to be made aware the patient was in hospital 50% of our patients had no codeable procedure

It boiled down to Before Emergency Alerts I could lose a patient admitted as an emergency

Impact on my known cancer patients care Did I know you had admitted? Are you getting the specialist care you need? Are you in a Medical Assessment to undergo test after test? Will I only know about you if I get seriously Ill, I pass you whilst on the wards or a relative calls>

After we implemented emergency alerts…. Do you know I have admitted? Am I getting the specialist care I need? Am I going to Medical Assessment to undergo test after test? Will you only know about me if I get seriously Ill, you pass me whilst on the wards or a relative calls>

How do we manage it alert sent to Smartphone if patient admits as an emergency CNS attends patient to resolve issues Patient receives timely treatment Speedy & supported discharge PROCESS We now manage to see at least 85% of our patients and those admitted out of hours or the weekend we catch the next day or Monday. Alert attendance is not mandatory or immediate its just a very useful tool to help us support our patients

Emergency Alerts The alert allows our early intervention and we can Arrange OP appointments Provide enemas and stoma care etc. Advise the MDT of IP status Provide support and signposting for patient, carers and junior Medics Co-ordinate care in the community

Operational Fit Alerts have placed an additional demand on the CNS but the Return on Investment is Reduced LOS Reductions in re-admission Staff Satisfaction Greater Access to AHPs and Palliative Care Improved patient experience and quality of care