hospital at night staz study trip 18 january 2009 tim lund divisional manager skills for health...
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Hospital at Night
StAZ Study Trip
18 January 2009
Tim LundDivisional Manager
Skills for Health Workforce Projects Team
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Hospital at Night
• Multi-disciplinary team working: right person, risk skills, right place, right time
• 2003 – 2005: Piloted and evaluated. National support in partnership with the London Deanery
• 2008 Survey: three quarters of trusts report having H@N services
• The “Case for Hospital at Night: the Search for Evidence” demonstrated improved patient safety
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Hospital at Night Update
• More evidence of Hospital at Night teams improving patient care
• Observational study at Edinburgh Royal Infirmary for 14 nights before and after implementing H@N found that:
- Patients were reviewed more frequently by senior medical staff
- Significant inter-specialty differences in response times eradicated
- Reduction in adverse patient outcomes from 17% to 6% (Defined as unplanned transfer to critical/cardiac arrest in the 18 medical/surgical wards and the Combined Assessment Unit)
• Source: QJ Med 2009; 102:539-546. Author Dr D.J. Beckett et al
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Hospital at Night and 24/7
• Bid for longer term study focussing on patient safety. Partners: Imperial, London Deanery, Royal Colleges, I.C.
• Targeted consultancy support to trusts still trying to establish H@N
• Indications - 24/7 solutions and hot & cold split/team work support the quality of patient care and can sustain training
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H@N introduced H@D&N introduced
National average
HSMR Data at Guy’s and St Thomas’: 2003 - 2008
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Confidence in H@N and 24/7 Longevity
• 24:7 solutions appear sustainable at Homerton, Guy’s & Tommy’s, South Devon & Royal Liverpool & Broadgreen
• Award winning solutions in place for about two years
• Consistent with Quality and Productivity agenda
• Wide support from stakeholders for quality solutions
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Development of H@N Tools / Support
• H@Nbleep system implemented in small number of trusts
• Robust handover systems available. We are sponsoring Salisbury to roll out H@N handover tool to 20 trusts
• 12 hour H@N e-learning course under development with London Deanery & DH. Core skills and curricula
• Opportunity for blended learning. Sustaining training vital
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Particular Value of Simulators
• Full immersion
• Complex multi and inter-professional working
• Particularly when linked to effective behavioural debriefing
Source: London Deanery
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Particular Value of Simulators
• Full immersion
• Complex multi and inter-professional working
• Particularly when linked to effective behavioural debriefing
Source: London Deanery
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Salisbury Salisbury Handover Handover
SystemSystem
With support from
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Salisbury H@N Handover Tool
• Multi-professional tool sponsored by Workforce Projects Team
• Designed by clinicians & developed by the users at all levels to ensure maximum utility
• Meets info governance and data protection requirements
• Provides a focus for handover. Handover list accessible across hospital by appropriate staff can be updated real-time!
Source: Salisbury
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Hospital at Night List
• Linked to Consultant List or can stand alone
• Correct patient details
• Management plan detailed
• Reason for H@N involvement
• Priority for review
• Accessed throughout the day
• Printed for H@N team
• Auditable
Source: Salisbury
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Helping to Make EWTD Manageable
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Contacts: Information
• Any Questions?
• Contact me via:
07771 3719180161 2662136
Further information: www.healthcareworkforce.nhs.uk