Upload
shana
View
46
Download
2
Tags:
Embed Size (px)
DESCRIPTION
A&E ATTENDANCES – NHS LOTHIAN. Sheila King. A&E Departments - Lothian. RIE – approx 105,000 atts per annum St John’s – some 47,000 attendances RHSC (paediatric unit) – 36,000 atts Minor Injuries Unit at Western General Hospital site in north of city – 18,000 patients per annum. - PowerPoint PPT Presentation
Citation preview
A&E ATTENDANCES – NHS LOTHIAN
Sheila King
A&E Departments - Lothian
• RIE – approx 105,000 atts per annum
• St John’s – some 47,000 attendances
• RHSC (paediatric unit) – 36,000 atts
• Minor Injuries Unit at Western General Hospital site in north of city – 18,000 patients per annum
Trends in attendance – November to June
• November 08 to June 09 compared to Nov 07 to June 08
• RIE A&E up 3%• St John’s up 9%• RHSC up over 8%• WGH MIU only increased by 1%• Proceed to analyse 3 main sites over 4 months
March to June 2009
Referral source by site
%AGE OF ALL A&E ATTENDANCES ACCOUNTED FOR BY MAIN SOURCES OF REFERRAL
0%
10%
20%
30%
40%
50%
60%
70%
80%
999 Emergency Self referral GP NHS24
RIE
St John's
RHSC
Triage Category
%AGE OF ALL A&E ATTENDANCES ACCOUNTED FOR BY MAIN TRIAGE CATEGORIES
0%
10%
20%
30%
40%
50%
60%
70%
80%
Standard Urgent Very Urgent Imm Resus
RIE
St John's
RHSC
Arrival Mode
%AGE OF A&E ATTENDANCES ACCOUNTED FOR BY MAIN ARRIVAL MODES
0%
10%20%
30%
40%
50%60%
70%
80%
Private transport Emergencyambulance
Urgent ambulance(GP)
Public transport
RIE
St John's
RHSC
% age band – all 3 sites
PROPORTIONATE USAGE OF A&E BY AGE BAND
0
2
4
6
8
10
12
14
16
18
0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 Over 75
%of A&E
% of Lothian popl
% age admitted from A&E
Percentage of A&E attenders admitted by site
0%
5%
10%
15%
20%
25%
30%
RIE St John's RHSC All
% admitted by age bandPERCENTAGE OF A&E ATTENDERS ADMITTED
0%
10%
20%
30%
40%
50%
60%
70%
0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 Over75
RIE
St John's
RHSC
All
% age by arrival hour by site
%AGE OF A&E ATTENDANCES BY ARRIVAL HOUR
0
1
2
3
4
5
6
7
8
9
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
RIE
St John's
RHSC
% age discharges to “GP care – no further appointment”PERCENTAGE OF DISCHARGES FROM A&E TO
"GP CARE - NO FURTHER APPOINTMENT"
0%
10%
20%
30%
40%
50%
60%
70%
RIE St John's RHSC
Did Not Waits
• RIE and St John’s – a total of 1236 patients left without being seen in 4 months
• 736 (62%) left within 2 hours of arrival
• 25% of did not waits arrived by emergency ambulance
• 50% were in the age group 15 to 34
Conclusion
• 3 very different A&E departments• Disproportionate usage of A&E greatest among 0-4,
5-14, 15-24 and over 75 year olds • Admission from A&E increases markedly with age• Attendances by arrival hour – very obvious peak 6-
7pm RHSC, 6pm St John’s, late morning RIE• Surprising issues around “did not waits”, many leaving
within 2 hours, 25% arriving by emergency ambulance• Proceed to look to try to find some pointers around
increased activity, particularly evident on RHSC and St John’s sites
RHSC – March to June 09 vs March to June 08
• 7% increase in A&E attendances• Large increases in 999 emergency and GP sources
of referral• Age band 0-4 increased attendances by 27% (rising
birth rate but disproportionately high increase in A&E att) – all other age bands reduced
• Admissions from A&E down – both %age admission rate and overall number of admissions (despite 7% increase in A&E attendance
St John’s – March to June 09 vs March to June 08
• 5.5% increase in A&E attendances• Age band 0-4 increased attendance by 27%, 5-14
increased by 10%• Over 55% of increase accounted for by 0-14 year
olds at St John’s A&E• Admissions from A&E down – both %age admission
rate and overall number of admissions (despite increase in A&E attendance)
• Admission rates down by 17% in 0-14 age group and by 15% in 15-24 year old age group
RIE – March to June 09 vs March to June 08
• 3.7% increase in A&E attendances• 55% increase in 5-14 year old age group, 8%
increase in 15-24 age group and 7% in 65-74 age group
• Admission rate from A&E down v. slightly from 28.9% to 28.2% (in total number of admissions up 1.4%)
• Increase in number of admissions accounted for mainly by 65-74 age group, but also 15-24 age group.
CONCLUSION
• A&E attendance rates increasing in all 3 A&E departments (based on 4 months 2008/2009)
• Younger age groups large contributor to increased attendances
• Admission rates from A&E down on all 3 sites – RHSC and St John’s – number of admissions down despite increased A&E attendance
• RIE site – 65-74 age group accounts for 70% of increase in admissions (but only 14% of increase in attendances)