Angela Pollock and Paula ForrestAssistant Service Managers
Royal Belfast Hospital for Sick Children
15 February 2013
Where are we now?Civil Eyes WorkshopsBenchmarking workshops for Acute paediatrics Benchmark with 15 other paediatric centres in
the UKHow do we compare / what do we need to
change?Scope Models of Care already in place
Surgical specialties: % day cases
Surgical specialties: % same day operations for elective activity
Surgical specialties: inpatient length of stay
30 Day emergency readmissions vs. length of stay – non-elective activity (excluding GOSH)
% Emergency readmissions within 7 days
% Emergency readmissions within 30 days
What has been achievedIntroduction of Day of Surgery UnitIntroduction of Pre assessmentCentralisation of service referrals which are
then triage to the appropriate care settingOrthopaedics / Asthma / Epilepsy
Scoping of OP clinics to move to Health and Well being centresDiabetes / General Medical
Next Steps 1: The Manchester ModelCCN managed within Acute Sector – based in
the same buildingAttend the daily COW ward round 7 days a
weekAid discharge processIdentify possible pathways for children to the
communityRotational Posts – set number every year
3 places over a year – 4 month placements eachA&E / SSPAU, Inpatient ward and Community
Working pattern8am to 10pm Monday to Friday
8am to 8pm Saturday and Sunday
On-call system to deliver care for End of LifeTo support Care Workers managing complex children in
the community
Possible referrals:IV AntibioticsDressingsSupport with enteral feedingFacilitation of equipment provisionOngoing family support/teachingDiabetes team Better Links with specialist services i.e.
CYSTIC FIBROSIS/ONCOLOGY
Next Steps 2: CRAFT teamCCN accepts referrals from any provider of
emergency/unscheduled care in an attempt to reduce the need for SSPAU/acute admission
Referrals also accepted for follow-up visits from ED/SSPAU/inpatient wards to facilitate safe earlier discharge
CCN visits within 4 hours of receiving referral
Working pattern
10am to 8pm 7days per week including bank holidays
Answer phone for non-urgent messages 24/7
Parents provided with appropriate contact numbers for out of hours support
Possible referralsHigh temperatures-fever managementVomiting and diarrhoea-hydration checksViral wheeze, bronchiolotis, asthma, croupCoughs, colds & pneumoniaEar & throat infectionsConstipationRashesGastro-oesophageal refluxHenoch-Schonlein PurpuraUTI
Interventions
Observation/monitoringAdministration of medicationCollection of laboratory samplesFamily supportTeaching of other professionals
Educational NeedsRotation posts for both local Trust and
regionallySimulation Training – updates for whole regionRegional standards for paediatricsStandardisation of services across NI for
paediatrics; equity of serviceWorkforce standardisation of roles, Band 6’s in
Special Needs Schools, Band 3 at home with ventilated Children
Modernisation of skill mix
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