Darzi project to reduce A&E attendances

Darzi project to reduce A&E attendances Patrick Farrell Consultant Paramedic BHRUT.

Despite an ever growing number of services and facilities provided at great cost, there is still one key question....

Why are increasing numbers of patients still coming to A&E?

How do you tackle a seemingly age old problem? By getting to the root cause

Is the patient really at the heart of what we produce?

The current system is increasingly complex and impossible to navigate, not only do both patients and clinicians not know what's available! there is no easy way to access the costly and available services.

Whatever we do, we can not simply repeat what has gone before. We must change a few key aspects and learn from our mistakes.

What are the real questions?

"It is becoming increasingly apparent, that we must capture the data "we need" and not simply to comply with targets. We must then utelise this data to facilitate a driven plan to effect realistic change."

So what, if anything, has this Darzi set in motion?

A committed drive to build effective relationships across the entire system and to ensure Trust support in key areas of the wider health community.

And help reshape 111 to create a single point of access for all.

The building of truly effective relationships & a genuine single point of access to services for all, may just provide the shift from having no influence over patient flow in to and through A&E departments, to providing everyone with the goals they require.

To date

The commissioning of a joint Trust / CCG respiratory steering group. The majority of our repeat users are COPD patients. Within this multi disciplinary group we are targeting several key aspects of the problem with three clear directives!

Combat the root cause with a continued focus on smoking cessation...

we have two patient empowerment seminars commissioned for July, to help us get to the root of the actual patient issues. Utelising the data we are bringing together the actual repeat users and the stakeholders involved .....

Lets Find out, WHY ARE WE FAILING YOU ?

Ensure the best practice in early diagnosis and gold standard treatment are standardized from our GPs to Discharge

Facilitated through the UEC steering group, we were pivotal in creating the ability for Paramedics and Initially two nursing homes to access the new 111 physician led hub trial... By Supporting the pre hospital with this live back door direct number, we are creating a true single point of entry.. the future of mutually achieved goals is absolutely embedded within real time in hospital support of pre hospital projects....

it is imperetive we ensure the value of the UEC steering group & the flow of ideas through our system is not lost by unnecesary layering of the decision tree

Championing the sharing of data to promote our own goals. Creating an electronic tagging of complex patients details on to the LAS dispatch system to allow point of entry identification of patients linked to established community based projects such as Health 1000. taking this initiative one step further by integration of this within our own symphony system.....

Data capture and mutual sharing is another pivotal area where if we truly commit the goals will be achieved!

Continued focus to support & empower shop floor staff for they are both the true solution holders and the future..........

A Reduction of mortality rates utelising sepsis data in a unique way. take the data and highlight where the true trends & risks are? then use this data and target the problem areas specifically & effectively ......

Sharing of sepsis & infection control training with nursing home staff, targeting the true ground zero and early recognition. There is also scope for this to become a steady stream of income generation for the trust..

Creating firm relationships throughout the trust by supporting other projects with common goals such as the "point of care" analysis across the trust. A wise man once taught me the value of Trojan mice and their effect within an evolving system..........

Ensuring BHRUT leads the way by thinking "Out of the box", with Innovative solutions such as paramedic direct referral to radiology.... who says it cant be done?

Paramedic direct referral to radiology & PAN London minor injuries agreement with LAS to help capitalize on radiology data & urgent care center support to shift some of the burden away from the front door...

there is still real scope to re-direct large numbers of appropriate patients to local UCC....

Stay focused and understand the true value and challenges of clinical leadership....

An apparent marked reduction in conveyances to queens A&E.

"It must be stressed that any reduction in conveyances to Queens A&E in the last few months are not simply a product of any one intervention, but the strong relationship and team work displayed by both those in the trust, CCGs & LAS."

Genuine thanks and appreciation to all who have put up with me over the past six months & those who have shared both their time and their knowledge............

Appreciate