I couldn't agree more Jeremy.
There seems little point in playing with door-to-bed times if you ignore
call-door times or even injury-door times (as we all know from
thrombolysis).
You can play with yourselves all you want re: getting the patient into a bed
within an hour etc.. But if the GP is getting a visit request at 9am, for a
fall that happened at 2am, and then visits at lunchtime and is sending them
in by ambulance as a "within 2 hours" category and you're pulling out all
the stops in A+E to see them within 10 minutes of arrival then what you are
doing makes no sense at all. Alternativly, if the GP gets a call for "'fall
can't get up distressed in pain" and leaves the surgery mid consultation to
joint respond with an ambulance 999 call, and then the patient sits in A+E
for 2 hours waiting to be seen, then again that's the left hand buttoning up
your shirt while the right hand unbuttons it.
Unless you include primary care, ambulance service and patient/carer
information, then Integrated Care Patheways aren't.
(for those of you who have just slogged your way through your x'th meeting
with the local Primary Care Group Integrated Pathway Steering Group, my
apologies - if such forward thinking exists please let the list know!)
Robbie Coull
mailto:[log in to unmask]
http://www.coull.net
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