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NHS Borders Development of Escalation Policy

NHS Borders Development of Escalation Policy. Dr. Simon Watkin Consultant Respiratory Physician Borders General Hospital simon.watkin@borders.scot.nhs.uk. Setting.

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NHS Borders Development of Escalation Policy

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  1. NHS BordersDevelopment of Escalation Policy Dr. Simon Watkin Consultant Respiratory Physician Borders General Hospital simon.watkin@borders.scot.nhs.uk

  2. Setting • NHS Borders Borders General Hospital Primary and Community Services Mental Health Social Services Scottish Ambulance Service Partnership forum • Population 106,500 • 280 beds total • 102 GIM beds including 30 MAU and 12 HD • 30 DME, 30 stroke/palliative/community

  3. Numbers

  4. Length of stay

  5. Why might you need an escalation plan? • 95+% bed occupancy • Delayed and cancelled surgery • 4 hour waiting breached • Medical boarders • Norovirus • Severe weather • Influenza

  6. Development of Escalation Policy • Executive support • Large scale 1 day event • Small working group weekly • Agreed policy • Executive mandate • Implementation group • “Thin” policy document • Clear operational arrangements

  7. Who was involved? • AHPs • Bed Management • BGH Clinical Board • Borders Emergency Care Services • Borders Improvement Support Team • Communications Team • Community Hospital Superintendents • Discharge Liaison • Domestic and Portering Services • Infection Control • IM&T • Mental Health Clinical Board • PACS Clinical Board • Pharmacy • Planning and Performance • Public and Patient Representatives • Scottish Ambulance Service • Scottish Health Council • Social Work • Voluntary

  8. Timescale • Concept April • Workshop June • Executive approval August • Implementation October

  9. Positives • Creative and innovative • Multi professional • Alignment of objectives • Better, safer treatment • Efficient • Cost effective

  10. Now what? • Implementation group • Data quality • Action cards • Patient flow action team • Monitoring • Trial period • Re-assess • Re-calibrate

  11. How do we set the whole system status? Red Red Red Amber Red Red Amber Amber Red Green Red Red Green Amber Red Green Amber Amber Green Green Red Green Green Amber Green Green Green

  12. What’s next? • Have we got the thresholds correct • Can all groups react in real time • Will we learn anything we do not already know • Equitable spread of risk • Common understanding

  13. "If you are too good at adjusting to the current system, you may never realise that the system needs changing“ Edward de Bono

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