1. NENC London Adult Critical Care Network Transfer audit

2. Why monitor Role of network to monitor transfers Documentation
Medico legal document
Audit to learn from incidents
Developing the training and competencies
Medico legal document (Aim to maintain the same professional and personal conduct that would be considered ‘good clinical practice’ in the normal working environment. A legal record of the transfer process being an essential piece of documentation.
Audit to learn from incidents ( shared learning,,
Developing training and competencies on going process
Standardising policy
Standardising policy

3. Background New books printed and distributed in 2018 3 parts
1 to patient notes (white)
1 goes with patient (blue)
1 form goes to the Network (pink)
Looking into developing and printing new books

4. Method in collecting data
Looking at the following from 478 pink sheets
Demographics
Level of care given prior to transfer
Incidents
Working diagnosis and organ supported
Status
Did not take in count PMH, age,

5. Results Level of care given on transfer
13 units transfer forms since July 2015
Barnet – 31
Homerton – 119
Newham – 53
North Mid – 87
Queens – 5
Queens Romford – 2
King Georges - 23
Royal Free – 23
Royal London - 31
St Barts - 35
Whipps Cross - 34
Whittington - 7
UCLH - 1

6. Results
13 units transfer forms since July Level of care on transfer in %

7. Results Working diagnosis/organ support on transfer

8. Working diagnosis/organ support transfer %
Results
Working diagnosis/organ support transfer %
Majority was transfer to specialist centres neuro, cardio, liver…
However 40% not recorded

9. Status of transfers - total 478
Results
Status of transfers - total 478
Emergency – 226
Urgent - 41
Very urgent - 87
Elective - 84
Non clinical – 16
Not recorded – 63
Repatriation – 51
Tertiary referrals - 18
With regards to status of transfer only 5 were non clinical probably due to bed shortage but no evidence as reason not given

10. Results Incidents 22 incidents 2 linked to equipment failure
13 incident recorded but no reason given
7 patient deterioration
very little information given with regards to incidents

11. Conclusion/recommendation
Level of care missing on previous audit 5 %, now 3%
Incidents 6.5 % where 4.6 % was due to patient deterioration
Working diagnosis/organ support 25% missing vs 40 % that was recorded on previous audit
Status of transfer 38% emergency vs 40% from previous audit, 11% vs 7 % not recorded
We are not able to trace down many information therefore we need to concentrate more on educating staff on documenting relevant information on transfer form

12. Recommendation New books distributed to all ITU units and A/E
Educate all units (fill out the forms, transfer training..)
On going project