Glenda Rongen/Andrew Taylor

On the Right Track Discovery

25 March 2010

What We Did• Provided a detailed analysis of Level 3 triage cases

by Diagnosis description and discharge method• Canterbury care pathway documentation requested• Clinical directors to carry out audit

What We Found• The most common cases for attendances at the ED are:

– Abdominal pain– Chest pain– Unknown– Asthma– General Medical exam– Syncope and collapse– Pneumonia– Cellulitis

• The documented clinical pathway for the common cases not yet received.

• The patient file review would require clinical judgment and discussion with doctor attending because all cases are different. Test stopped as it is not possible to extract this information from a provisional diagnosis. This information is best sourced by retrospectively auditing from the discharge diagnosis.

• Clinical director for Women and Children will undertake a retrospective clinical audit across paediatrics and gynaecology.

Patients inside of ED are sometimes over assessed and there are options available to overcome this issue.

Implementation of push/pull model from within the wards may reduce the time taken in waiting for a bed

What We Did

• Analysed trends in waiting time for a bed in ED

and compared to discharge times from the ward

What we found

• A high degree of correlation between discharge times in the ward and long waiting times within ED

A 3-2-1 analysis by diagnosis will clearly identify where delays have been encountered.

A 3-2-1 analysis by diagnosis will clearly identify where delays have been encountered.