All Acute Trusts experience peaks in demand due to various influences some of which are predictable, some are less predictable. The accumulation of critical factors will result in the build up of pressure within the organisation that often leads to crisis management when the situation has peaked.
This is where East Cheshire are using the ExtraMed Escalations module to faciliate the entire trust working as a team to manage Operational Risks in real time.
The current escalation status is display at the top of every screen on ExtraMed, which is used across the Trust on all ward areas and in the emergency department.
Common factors that influence the day to day functioning of the Trust a set of triggers were agreed and thresholds for these triggers were set using the experience of the clinical staff. Each trigger was given a Red Amber or Green status.
Each trigger is linked to a set of agreed actions which sit behind each of the triggers with advice on how to manage the situation. Staff update and monitor the system and act collaboratively to manage situations which would create an operational issue before they occur.
The ability to plan resource management has reduced the need to address the situation reactively and has allowed the Trust as part of an ongoing efficiency project to reduce the agency nurse spend.
Patient experience will inevitably be improved by reducing the number of significant escalation situations however this is difficult to evidence as there is no direct comparison.
The winter was extremely challenging with large numbers of patients admitted with influenza related illness and the impact of the severe weather. In addition the Trust lost 18 beds due to lack of clinical cover which for the organisation could have had a serious impact on patient flow. The preparation and the introduction of the new escalation triggers assisted staff to manage during this difficult period.
Val Ahern Director of Strategy and Deputy CEO said ”This development is innovative and has proved, over the winter period, to be an extremely effective way of enhancing our escalation procedures as well as ensuring the Trust situation is managed using a whole systems approach.”