Transcript Emergency Alerts for known Cancer Patients

Emergency Alerts for
known Cancer Patients
Sara Connor & Mandie Ballentine
Colorectal Clinical Nurse Specialist
Sandwell and West Birmingham
Hospitals Trust
Emergency Alerts…Why ?
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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
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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
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Working in Partnership with the Network we
wanted to identify the typical path of a patient
who admitted as an emergency.
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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
100%
90%
Percentage of Patients Seen
80%
70%
60%
50%
40%
30%
20%
10%
0%
CNS
Physiotherapist
Dietician
Social Services
Pain
Management
Outreach Team
Palliative Care
Team
Healthcare Role
"Patients Seen"
"Patients not Seen"
Case Manager
Discharge
Liason
US/MRI/CT/XR
Why were they presenting?
Emergency Admissions
Summary
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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
PROCESS
Email alert sent to Smartphone if
patient admits as an emergency
CNS attends patient to resolve
issues
Patient receives timely
treatment
Speedy & supported discharge
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
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The alert allows our early intervention and we
can
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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
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Alerts have placed an additional demand on
the CNS but the Return on Investment is
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Reduced LOS
Reductions in re-admission
Staff Satisfaction
Greater Access to AHPs and Palliative Care
Improved patient experience and quality of
care