Getting Emergency Care Right Power training pack

The Burning Platform… We urgently need to deliver emergency care that is safer, more effective and of a better quality than we do now. We all need to take ownership of the issues and deliver them all without fail and at the very earliest opportunity.

Why are you here? Can you tell every one of your patients exactly why they are here? Are you sure you know why you are here yourself? What should other people expect from you? –Patients, colleagues and the wider organisation? Do you deliver? The truth is we are not delivering. The truth is we should be providing care that is safer, more effective and of a better quality than we do now. We need to focus on FREED.

1. Facilitate effective discharge Ensure that all patients have an identified and recorded EDD within two midnights. Ensure that structured daily Board Rounds are conducted on all patients. TTOs completed throughout day and in advance of day of discharge. Peer review.

2. Right person, right place Every patient should be triaged within 15 minutes. RAT service in majors. Consultant decision to admit.

3. Early specialist input Specialist teams to see every patient in ED/AMU referred by a senior decision maker within 30 minutes of referral to assess patient and document their review and plan in notes. A ‘Hot’ clinic appointment to be available for every patient that would benefit from one.

4. Eliminate unnecessary diagnostics Have a documented process in place to ensure e-RA is reviewed daily. Question whether a diagnostic test will alter management. Question whether the investigation can be performed as an outpatient.

5. Daily senior review Assess patient needs at beginning of the day. Review medication. Actions for the day. Record Care Plans to ensure continuity of care.

As a Healthcare Support Worker … My aim is to provide the best emergency care for our patients, and I will : Ensure all the observations are complete ready for the rounds at 8am. Set up the notes trolley in order for the round to run smoothly. Coordinate bed cleaning to ensure fast turnaround and pull up next admission.

As a Staff Nurse… My aim is to provide the best emergency care for our patients, and I will : Ensure that I complete all tasks on Board Round to ensure speedy discharge. Ask each patient every day if they know: –What is wrong with them? –What is going to happen today and tomorrow? –What do they need to achieve to get home? –When are they going home? Challenge the EDD to reduced LOS.

As a Junior Doctor… My aim is to provide the best emergency care for our patients, and I will : Assess patient needs every day. Ensure TTOs are completed before 12 noon the day before discharge wherever possible. Ensure investigations are only requested when appropriate and if required are requested and reviewed promptly.

Who is responsible for looking after Ada? ED? Specialist consultants? Your colleagues? Someone else? No It is you – you are responsible for her and her care.