patient arrives at emergency department triage nurse emergency dept 2 nd nurse review emergency dept...

PATIENT ARRIVES AT EMERGENCY DEPARTMENT

TRIAGE NURSE EMERGENCY

DEPT

2ND NURSE REVIEW

EMERGENCY DEPT

MDT MEETING

AYRSHIRE CENTRAL

BIGGART HOSPITAL

COMMUNITY HOSPITAL

STEP DOWN BED

HOME

CDU

2 BEDS 24 HRS

72 HR ASSESSMENT BED

5D/5E

WARD 3E

HOME

IN PATIENT BED

FRAIL ELDERLY PATHWAY

PATIENT IDENTIFIED AND LISTED AS POTENTIAL FOR PILOT BY ADMIN STAFF

FRAILTY INDEX SCORE CALCULATEDFRAIL

ELDERLY PILOT TEAM REVIEW

HELD IN REAL TIME IN THE E.D. AS AND WHEN REQUIRED

TEAM IN ACTION

TEAM STILL IN ACTION

Monday 13th May 2013

Feel a bit apprehensiv

e

In general, worked

relatively well on first day

Excited about the

possibilities that this

offers

Positive experience, good that it was a bit quieter today to get to grips with

processCap of 8 removed

Med rec

timing crucial

Red dot process

Getting to grips with

ED processes

Needs co-ordination

Pleased that we all got through

it

Over 65 : 22 (5 for pathway.)

3 to CDU (would have gone to 3E)

2 home

Total admissions avoided: 3

2 empty beds at 5pm

9am 4pm

Tuesday 14th May

Good examples of

making a difference

Much more natural

slotting in of MDT today

Admin co-ordination

made a huge impact

Can’t underestimate the impact of having Dr Wallace in ED

GP joining team

Sleepless night

Keeping track on patients

Impressed with the

progression

Huge difference

made

Empty beds in 3E – that

never happens!

Staff excited after

yesterday

Amazing! Revolutionis

ed the service!

Over 65: 29 (16 for pathway.)

12 home(2 NH). 2 to 72 hr beds.

1 to 5D. 1 to 3E.

Total admissions avoided: 9

8 empty beds at 5pm

9am 4pm

Friday 17th May 2013

It’s Friday!

A quick chat with ED staff this morning

to clarify processes

Having MDT meetings on the

floor rather than coming

up. Saving time

Not the same amount of

stress in the wards

Huge impact on 3E having

empty beds

Not so many people sent to

3E – most going straight

to ward

Pts seem to have been

safely discharged in

a shorter period of time

Some minor adjustments

Early contact

with families, invaluabl

e

9am 4pm

10 empty beds in 3E

OUTCOMES

‘AVOIDED’ ADMISSIONS

ED JOURNEY TIMES IN CONTROL GROUP

ED JOURNEY TIMES DURING PILOT WEEK

ED JOURNEY TIMES OF UNDER 65’S CONTROL GROUP

ED JOURNEY TIMES FOR <65’S IN PILOT WEEK

TIME TO COMMENCE GCA