Trust Board papers November 2012 - Barking Havering and ...

Performance for September
Emergency Care Pathway Report
Four Hour Maximum wait in ED
In September the Trust failed to meet the 95% standard and has deteriorated from August. The Trust achieved Trust 89.37% with Queens at 85.14 and KGH at
95.79%
Ambulance Offload Times
There were 14 black breaches in September all of which occurred during the week beginning 17 th September. Full SI investigations have been done for each patient
and in the main these were caused by lack of bed availability during that week.
Urgent Care Workstream
A significant amount of work has been undertaken within the UCC and the number of breaches in the UCC in August was 4 this is a significant improvement form the
July figure of 174.
Additional actions are being taken and monitored with the Director of Transformation as part of the ongoing action plan for the RESET sustainability programme.
These are:
1. Implemented ED Actions
1.1 Daily Performance Management
• ED breaches are discussed daily with the ED doctors involved to review if alternative management plans could have been taken and provide educational feedback to
prevent reoccurrence.
• Specialty breaches have reduced and any that occur are fed back to the specialties concerned to discuss with their teams.
• Daily performance information is shared with ED seniors both nursing and consultants to identify trends and agree actions to prevent reoccurrence.
• Daily peer challenge of decision making at board rounds and identifying alternatives to referrals by using alternative care pathways such as ambulatory care / virtual
ward is completed.
• Daily productivity monitoring is completed by consultants and performance issues are fedback to juniors
1.2 ED Workforce Actions
• Recruitment of doctor’s ongoing, SHOs and middle grades appointed last week.
• Paediatric ED consultant post advertised and General ED consultant in progress for advertising.
• Review of Senior Medical Cover on the Weekends has been undertaken and additional middle grade shift has been implemented as a trial for Saturday and Sunday
• Clinical Nurse Director in post in Emergency Care
• Review of KGH nursing workforce has been undertaken by the Clinical Nurse Director
• Review of Paediatric workforce to be commenced
• Review of RAT nursing workforce to be undertaken
• Competency skillset has been completed for OIC role, training to be developed with a plan to implement by mid-November
1