Sepsis care in UK Emergency Departments is improving

Sepsis care is improving but treatment needs to be faster, according to a new audit by the Royal College of Emergency Medicine.

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Image source: http://www.rcem.ac.uk

The report published this month audited 13,129 adults presenting to 196 Emergency Departments (EDs), and was endorsed by the Sepsis Trust.  It shows an improvement in the proportion of patients receiving the best care for severe sepsis and septic shock, but that improvements are needed to make treatment available faster.

The audit is designed to drive clinical practice forward by helping clinicians examine the work they do day-to-day and benchmark against their peers, and to recognise excellence.  There is much good practice occurring and RCEM believes that this audit is an important component in sharing this and ensuring patient safety.

The report finds that there has been a steady improvement in the ‘Sepsis-Six’, an initial resuscitation bundle designed to offer basic interventions within the first hour of arriving at an ED. However, despite seeing improvements in care, the report finds that RCEM standards are not yet being met by all EDs.

Full report:  Severe Sepsis and Septic Shock. Clinical Audit 2016/17

Emergency department frequent users

Birmingham, L.E. et al. BMC Emergency Medicine | Published online: 10 May 2017

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Background: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted.

 

Conclusion: This study characterized ED frequent users and identified several opportunities to better serve this population. By understanding barriers to care from the patient perspective, health systems can potentially address unmet needs that prevent wellness in this population.

Read the full article here

Patient flow within UK emergency departments

Mohiuddin, S. et al. (2017) BMJ Open. 7:e015007

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Objectives: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK.

 

Conclusions: We found that computer simulation can provide a means to pretest changes to ED care delivery before implementation in a safe and efficient manner. However, the evidence base is small and poorly developed. There are some methodological, data, stakeholder, implementation and reporting issues, which must be addressed by future studies.

Read the full article here

Emergency departments under pressure

The Institute of Health Care Management has published The Winter’s Tale: leadership lessons from emergency departments under pressure.

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Image source: ihm.org.uk/

The report focuses on the processes and behaviours of the emergency teams that are managing to deliver outstanding results despite the ever increasing challenges.

This report highlights the importance of using data to identify and shape solutions to the pressures in emergency departments.  It identifies key lessons for managers working in or with emergency departments.

The full report can be read online here.