NENC London Adult Critical Care Network Transfer audit

1. NENC London Adult Critical Care Network Transfer audit

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

3. Background New books printed and distributed in 2018 3 parts • 1 to patient notes (white) • 1 goes with patient (blue) • 1 form goes to the Network (pink)

4. Method in collecting data Looking at the following from 478 pink sheets

5. ResultsLevel of care given on transfer 13 units - 478 transfer forms since July 2015 Barnet – 31 Homerton – 119 Newham – 53 North Mid – 87 Queens – 5 Queens Romford – 2 King Georges - 23 Royal Free – 23 Royal London - 31 St Barts - 35 WhippsCross - 34 Whittington - 7 UCLH - 1

6. Results 13 units - 478 transfer forms since July 2015Level of care on transfer in %

7. Results Working diagnosis/organ support on transfer

8. Results Working diagnosis/organ support transfer %

9. Results Status of transfers - total 478 • Emergency – 226 • Urgent - 41 • Very urgent - 87 • Elective - 84 • Non clinical – 16 • Not recorded – 63 • Repatriation – 51 • Tertiary referrals - 18

10. ResultsIncidents 22 incidents • 2 linked to equipment failure • 13 incident recorded but no reason given • 7 patient deterioration

11. Conclusion/recommendation • Level of care missing on previous audit 5 %, now 3% • Incidents 6.5 % where 4.6 % was due to patient deterioration • Working diagnosis/organ support 25% missing vs 40 % that was recorded on previous audit • Status of transfer 38% emergency vs40% from previous audit, 11% vs 7 % not recorded

12. Recommendation • New books distributed to all ITU units and A/E • Educate all units (fill out the forms, transfer training..) • On going project