NENC London Adult Critical Care Network Transfer audit Why monitor - PowerPoint PPT Presentation

NENC London Adult Critical Care Network Transfer audit

Why monitor • Role of network to monitor transfers • Documentation • Medico legal document • Audit to learn from incidents • Developing the training and competencies • Standardising policy

Background New books developed July 2015 3 parts  1 to patient notes (white)  1 goes with patient (blue)  1 form goes to the Network (pink)

Method in collecting data Looking at the following from 102 pink sheets

Results Level of care given on transfer 8 units - 102 transfer forms since July 2015 • • Barnet - 5 Royal Free - 10 • • Homerton - 12 Royal London - 20 • • Newham - 10 Whipps Cross - 11 • • North Middlesex - 31 Whittington - 3

Level of care given on transfer 8 units - 102 transfer forms since July 2015 Level of care on transfer in %

Results Incidents 7 incidents  1 linked to equipment failure  1 incident recorded but no reason given  5 patient deterioration

Results Working diagnosis/organ support on transfer 14 13 Working diagnosis/organ support on transfer 12 10 9 8 7 6 6 6 6 5 4 4 3 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 Whittington Whipps Cross The Royal London RFH North Mid Newham Homerton Barnet

Results Working diagnosis/organ support transfer % Working diagnosis/organ support on transfer Neuro 13% Cardio Not Recorded 13% 40% Respiratory 7% Gastro/liver 11% Genito- Musculosceletal urinary 4% 8% Burns Poisoning Endocrine /metabolic 2% 1% 1%

Results Status of transfers - total 102  Emergency – 41  Non clinical – 5  Urgent - 7  Not recorded – 7  Very urgent - 13  Repatriation – 6  Elective - 21  Tertiary referrals - 2 Status of transfers 45 40 35 30 25 20 15 10 5 0 Emergency Urgent Very Urgent Elective Non Clinical Not Recorded Repatriation Tertiary referalls

Conclusion/recommendation • Level of care missing on 5 % • Incidents 6.5 % where 4.6 % was due to patient deterioration • Working diagnosis/organ support 40 % missing • Status of transfer 40% emergency, 7 % not recorded

Recommendation • New books • Educate all units (fill out the forms, transfer training..) • On going project Understanding before and after the course 6 5 4 3 2 1 Understanding before? 0 Understanding after?