A&E Clinical Quality Indicators June 2013

Transcription

1 A&E Clinical Quality Indicators June 2013 (RJE) Initial Assessment Treatment Total time in A&E Patient arrives in A&E % of patients waited under 17 minutes from arrival to initial assessment 1.2 On average, patients waited 63 minutes from arrival to treatment 95% of patients waited under 343 minutes from arrival to departure % of patients not requiring admission to hospital waited under 237 minutes from arrival to departure % of patients who needed admission to hospital waited under 477 minutes from arrival to departure Re-attendance Left without being seen Legend % of attendances this month were unplanned reattendances % of attendances this month left the department before being seen Service Experience Successfully meets development standard Does not meet development standard 1.7 Overall summary of performance

2 Time to Initial Assessment in A&E (Click here for full description of measure and target) 2013 January February March April May June Median th Percentile Longest Wait In June the median time to initial assessment of all patients attending the Emergency Department by ambulance remains at 3 minutes. The 95th percentile has reduced further to 17 minutes which is just outside the standard of 15 minutes, representing steady improvement and reflects the sustained hard work and commitment of the whole team. The longest any patient had to wait to see a nurse in triage was 69 minutes which represents the best performance achieved by the Emergency Department in 2013.In June the median time to initial assessment of all patients attending the Emergency Department by ambulance remains at 3 minutes. The 95th percentile has reduced further to 17 minutes which is just outside the standard of 15 minutes, representing steady improvement and reflects the sustained hard work and commitment of the whole team. The longest any patient had to wait to see a nurse in triage was 69 minutes which represents the best performance achieved by the Emergency Department in Page 2 of 10

3 Time to Treatment in A&E (Click here for full description of measure and target) 2013 January February March April May June Median th Percentile Longest Wait The median time to treatment in June is recorded at 63 minutes (standard 60 minutes). The Emergency Department continues to utilise the RAT (Rapid Assessment and Triage) process, implemented over the past few months, for all patients presenting to the Department. We endeavour to keep the RAT process in place so we can aim to achieve this target. Page 3 of 10

4 Time in A&E for Admitted Patients (Click here for full description of measure and target) 2013 January February March April May June Median th Percentile Longest Wait In June the median total time spent in the Emergency Department for admitted patients is 215 minutes. The 95th percentile total time for patients admitted has reduced further to 477 minutes. Capacity on various days within the Trust allows for transfer of patients to the appropriate speciality in a timely manner, however, the longest time a patient waited to be admitted into a hospital bed from the Emergency Department has improved to 910 minutes. This represents a particularly busy weekend (8-10 June inclusive) where capacity/flow within the Local Health Economy was the main obstacle to achieving this standard. Actions to achieve the Total Time in the Emergency Department for Admitted Patients (95th percentile 240 minutes): - - The local NHS has a dedicated action plan to improve A&E performance - There is a weekly review of A&E performance with the Chief Operating Officer and Executive leads Page 4 of 10

5 Time in A&E for Non - Admitted Patients (Click here for full description of measure and target) 2013 January February March April May June Median th Percentile Longest Wait The Emergency Department is proud to have achieved the total time in the Emergency Department for non-admitted patients in June at 237 minutes (95th percentile standard 240 minutes). Despite huge pressures facing the Trust on a daily basis, the emergency department staff have once again worked together as a team to try to maintain a very high level of nursing and medical care. The majority of patients that attended the Emergency Department in June were seen, investigated, treated and discharged within 4 hours of arrival. Page 5 of 10

6 Patients left before being seen (Click here for full description of measure and target) The Emergency Department continues to achieve this standard recording a figure of 3.2%. This remains within the standard of less than 5%. Page 7 of 10

7 Un-planned re-attendances (Click here for full description of measure and target) The unplanned reattendance rate for June is recorded as 5.7% (standard less than 5%). We will continue to dedicate our efforts in working closely with primary care colleagues in implementing specific care plans for patients who frequently attend the emergency department. We hope this dedicated approach helps us to consistently improve, enabling us to achieve this standard. Actions: The Emergency Department continues to look at the most frequent reattenders and is using a multi-disciplinary approach to identify solutions on an individual patient basis. Page 9 of 10

8 Summary: In June 9692 patients attended the Emergency Department. The Department is proud of the hard work and commitment of staff in achieving 2 of the 6 Clinical Quality Indicators in June. Every effort continues to be made from within the Emergency Department and the Local Health Economy to help us achieve the Clinical Quality Standards. Our focus continues to be the delivery of high quality, safe clinical care for our patients. The Local Health Economy will continue to focus on improving flow through and out of the organisation which will in turn support the future achievement of these Clinical Quality Indicators.

9 A&E Clinical Indicators Glossary of Terms and Targets Emergency Department (ED) is the name for University Hospital Accident & Emergency Department. Admitted Patients Admitted as an inpatient to hospital following their visit to A&E. Non - Admitted Patients Patients who are discharged from the A&E Department after treatment without requiring admission to hospital. Initial Assessment The initial assessment is when a patient is assessed by an emergency care doctor or nurse to allow them to determine a priority for treatment (sometimes called triage). The assessment would normally include a brief history of the patient s condition, pain score and vital signs (blood pressure, temperature, pulse). Target: A 95th Percentile time to assessment at or below 15 minutes. Left without being seen A patient who leaves without being seen is one who registered with the receptionist in the A&E department but then left the department before they saw a doctor. Target: A rate at or below 5%. Treatment time The treatment time is the time when a patient is seen by a doctor who can diagnose the problem, decide the management plan for the patient and arrange or start treatment if required. Target: A median wait at or below 60 minutes. Page 10 of 10

10 Unplanned re-attendance An unplanned re-attendance is where a patient returns to an A&E Department within 7 days of a previous A&E attendance. This may be for the same condition or a different one. Target: A rate at or below 5%. Total time in department The time a patient spends in the A&E department under the care of hospital staff. Target: A 95th percentile wait at and below 4 hours. Target A&E departments are expected to show continuous improvement against the new clinical quality indicators over time. The Department of Health has set minimum performance standards which trusts must aim to meet and exceed where possible. 95th percentile The 95th percentile time is the time below which the majority (95%) of waiting times may be found. If all the waiting times were put in order from shortest to longest, the 95th percentile would be 95% of the way down the list. Median The median time is the time that separates the upper half of all the times from the lower half. If all the waiting times were put in order from shortest to longest the median would be the middle value. This is not the same as average. Page 10 of 10