Emergency Alerts for known Cancer Patients

Sara Connor & Mandie BallentineColorectal Clinical Nurse Specialist

Sandwell and West Birmingham Hospitals Trust

Emergency Alerts…Why ? We often accidentally discovered patients known to

us when we were on the wards or a relative phoned When we became aware of the patients after

several inpatient days we found Patients under the wrong team Patients who should be brought to the attention of the MDT Patients undergoing unnecessary diagnostics Patients whose needs we could have managed in hours or

a couple of days. How could we match our expertise and emotional

support on elective pathways for our emergency patients?

Pan Birmingham Cancer Network

Working in Partnership with the Network we wanted to identify the typical path of a patient who admitted as an emergency.

20% of all the Emergency Admissions over a two year period were reviewed using patient casenotes and HES data.

Who did the patient see ?

Emergency Admissions - Health Record Audit - Health Care Role Interactions

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CNS Physiotherapist Dietician Social Services PainManagement

Outreach Team Palliative CareTeam

Case Manager DischargeLiason

US/MRI/CT/XR

Healthcare Role

Per

cen

tag

e o

f P

atie

nts

See

n

"Patients Seen" "Patients not Seen"

Why were they presenting?

Emergency Admissions Summary

Patients admitted as an emergency did not have a journey as well facilitated as our elective patients or those admitted as an emergency with a new primary

Admittance into MAU and then Gen Med meant we, the colorectal team, were unlikely to be made aware the patient was in hospital

50% of our patients had no codeable procedure

It boiled down to Before Emergency Alerts I could lose a

patient admitted as an emergency

Impact on my known cancer patients care

Did I know you had

admitted?

Are you getting the specialist care you

need?

Are you in a Medical

Assessment to undergo test after

test?

Will I only know about you if I get seriously Ill, I pass you whilst on the

wards or a relative calls>

After we implemented emergency alerts….

Do you know I have admitted?

Am I getting the specialist

care I need?

Am I going to Medical

Assessment to undergo test after

test?

Will you only know about me if I get seriously Ill, you

pass me whilst on the wards or a relative calls>

How do we manage it

Email alert sent to Smartphone if patient admits as an emergency

CNS attends patient to resolve issues

Patient receives timely treatment

Speedy & supported discharge

PROCESS

We now manage to see at least 85% of our patients and those admitted out of hours or the weekend we catch the next day or Monday.Alert attendance is not mandatory or immediate its just a very useful tool to help us support our patients

Emergency Alerts

The alert allows our early intervention and we can Arrange OP appointments Provide enemas and stoma care etc. Advise the MDT of IP status Provide support and signposting for patient,

carers and junior Medics Co-ordinate care in the community

Operational Fit

Alerts have placed an additional demand on the CNS but the Return on Investment is Reduced LOS Reductions in re-admission Staff Satisfaction Greater Access to AHPs and Palliative Care Improved patient experience and quality of

care