Post on 18-Jan-2016
Emergency Alerts for known Cancer Patients
Sara Connor & Mandie BallentineColorectal 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 ?
Emergency Admissions - Health Record Audit - Health Care Role Interactions
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
CNS Physiotherapist Dietician Social Services PainManagement
Outreach Team Palliative CareTeam
Case Manager DischargeLiason
US/MRI/CT/XR
Healthcare Role
Per
cen
tag
e o
f P
atie
nts
See
n
"Patients Seen" "Patients not Seen"
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
Email 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