'In Leeds, the involvement of senior clinical staff in A&E in a patient's
assessment from an early stage minimses waiting and ensures appropriate
care. Research shows that this can reduce the number of patients with
emergency needs who re admitted to hospital by between 10 and 20%.'
Reforming Emergency Care Document
Anyone from Leeds out there working this at the moment ? Does it work ?
What is the 'research' ? Is this about senior involvement in majors and
minors ? To institute this in all hospitals 16 hours a day will take far
more than 183 new consultants in the UK by 2004.
Doctor triage seems to me an attractive idea. Eyeballing the patient,
organizing investigations without necessarily following these through
personally, re-routing those best seen elsewhere, could be done pronto by
staff grade / Spr / Consultant. At the moment, there are not the staffing
levels, but possibly an escalation policy, so that this could be started
if patient numbers increase above a certain level. Or sessions round the
times when patients roll up fastest. I can see inequities around this, but
the fact remains, we have to change our working practices somehow, and
plainly the present system just does not seem to work.
I hear the London Hospital has just ended a trial period of doctor initial
assessment, seemed to be guardedly optimistic about it.
Likewise, guardedly optimistic,
Paul Ransom
----- Original Message -----
From: Cliff Reid <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, March 17, 2002 5:31 PM
Subject: Re: Reforming emergency care
> AUGUST 2000, Acad-ae-med:
>
> "Currently in our departments, as you know, the best consistent level of
> patient care offered is that provided by the least competent SHO (or maybe
> nurse practitioner). Increasingly I believe this will not be tolerated,
and
> with due respect to these SHOs (or Nurses) nor should it be"
>
> Tony Good
> Consultant A&E
> Liverpool
>
>
> "The public are not stupid and will demand this of the politicians and
> providers"
>
> John Chambers
>
>
> MARCH 2002, Dept of Health Streaming document:
>
> "All accident and emergency departments have resuscitation facilities in
> place. Plans should be in place by March 2002 to develop a system that
> ensures a person of appropriate seniority assesses patients in triage
> categories 1& 2."
>
>
> Wanna tell me some lottery numbers, chaps?
>
>
>
>
> Cliff Reid
> Registrar in paediatric critical care
> Australia
>
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