ALERT™ AWARE™ & BEACH™ Network Day Tuesday 26th September 2017 Holiday Inn, Birmingham

Introduction The Team Fire procedures Facilities Mobiles Bev, Pip, Laura, Mandy, Helen, Mark introductions.

Morning Programme 09.30 – 10.00 Coffee and Registration 10.00 – 10.20 Welcome and ALERT™ HQ Update 10.20 - 11.05 Human Factors – Mark Hellaby 11.05 – 11.30 Coffee and Networking 11.30 – 12.00 Paediatric ALERT™ Update 12.05 – 12.45 BEACH™ V2 Update

Afternoon Programme 12.45 - 13.30 Lunch & Networking – Lancaster 3 Foyer 13.30 – 14.15 Human Factors Development Workshop - Your Vision 14.15 – 14.30 Quality Assurance Guidance Q & A 14.30 – 14.45 Evaluation & Close

Any Questions?

Beverley Stockwell ALERT™Senior Clinical Educator ALERT™ HQ Update Beverley Stockwell ALERT™Senior Clinical Educator

Review of the Last year Team update New Scenario New centres Regulations Updated Manual Updates Quality Assurance Social Media Our first year scot now anna Inadequate Analgesia ACTION™ Melbourne, Perth and SECAMB Manual – breathing diagram & new sepsis pathway Social media – linked in, twitter, new website

Overview of the year ahead Paediatric ALERT™ Course BEACH™ V2 piloted BEACH™ within the community Network Day - Oct 2018 Teaching Guidance Increase course centre visits Human Factors update

Any Questions?

ALERT™ HQ @ALERT_Course ALERT™ Course Headquarters www.porthosp.nhs.uk/departments/alert

Clinical Educator ALERT™ & Resuscitation BEACH™ V2 Update Laura Wood Clinical Educator ALERT™ & Resuscitation

Learning Outcomes Overview of the last year – Clinical Lead for BEACH™ Following Network Day 2016, you said…. Following Network Day 2016, I did….. Brief overview of what I have been doing in the last year with BEACH. Importance to stress that following network day we pulled together your themes and this is where we think we are going with it.

Overview of the last year ALERT™ HQ - Engagement and scoping exercise with course centres ALERT™ HQ - Support with new BEACH™ centres ALERT™ HQ - BEACH™ Manual update PHT - Significant increase in PHT BEACH™ courses including bespoke obstetric BEACH™ course ALERT™ HQ - Development of Record of Learning PHT - Exploring BEACH™ within the community setting Following network day last year completed a scoping exercise engaging course centres regarding the potential amalgamation of the BEACH and AWARE courses so get an overview of opinions. Generally happy with just one course, as long as the content remains truthful to BEACH and AWARE and core content from AWARE to remain. Plan going forward to still have half day programme, with an extended element available with scenarios for more advanced unregistered healthcare staff. Or extended version to include organisations own induction health care support worker programme followed by new BEACH V2 programme in the afternoon. New BEACH centres in the last year. Visited OXFORD in July to watch their BEACH course. Ongoing development with the BEACH V2 update manual. New content includes; Sepsis, accountability and delegation, human factors, fluid balance and AKI, diabetes, more focus on work book style like current AWARE booklet. Theory and content linked to Care certificate standards and KSF framework. See massive increase in PHT BEACH courses, very popular course. Development of the Record of Learning. This is similar in style to the ALERT ROL and references the Care certificate standards. In development to take BEACH within the community. Exploring possible of this, and have been in contact with primary care organisations in developing this within the community. Looking at an income stream for the organisation. If you want more info then please catch up with me at coffee.

Course Centre Feedback “Combine BEACH™ and AWARE™ courses” “Full day is best to incorporate” “To include elements of the Care Certificate” “Workbook style manual , like AWARE™” “Scenario based like ALERT™ in the afternoon” “BEACH™ as a half day” “Add in Sepsis and AKI” “Competency based” “Essential physiological teaching required” “BEACH™ as a full day” “…keep the prioritisation exercise” “more group work and table top discussions” “AWARE is a good foundation” Following last years network day we wanted to explore course centres moving forward with what was available for your band 1-4 workforce. Explore what course centres thoughts were regarding the two courses. Following the network day I reviewed the paperwork from the course centres and the overall feedback of the courses was to combine them (dependant on how the course will look and its structure). We recognise at HQ that finances are tight within healthcare organisations and it is potentially more cost effective to have one course rather than two. We also recognise those course centres who only run the AWARE course, and we will endeavour to fulfil this gap with the look of BEACH V2 to have a lot of content from the AWARE courses and have a workbook style manual similar to that for AWARE. Scoping exercise this year to see how course centres generally felt about this potential movement for ALERT HQ, and overall most course centres agreed with the one course strategy going forward.

Example of a BEACH™ V2 Template half day programme Suggested minimum timings (can be extended) Topic Essential Content ESTIMATED TIME   09.00 - 09.15 Welcome and Introduction Setting the Scene Suboptimal Care Why are you here at the BEACH™? Yes 15 minutes 09.15 - 09.30 BEACH™ Systematic Assessment Framework (local NEWS & Escalation) 09.30 – 10.15 Accountability and Documentation – Human Factors Case Study 45 minutes 10.15 – 10.35 Sepsis 20 minutes 10.35 – 10.45 COMFORT BREAK 10 minutes 10.45-11.15 Airway Assessment and Alertness 30 minutes 11.15 – 11.45 Breathing Assessment 11.45 – 12.30 Circulation Assessment & Disability (Including Fluid Balance and AKI) 12.30 -13.30 Handover, Escalation and Communication Tool (SBAR) including prioritisation exercise 60 minutes 13.30 – 13.35 Evaluation and Close 5 minutes Still half day programme to enable flexibility to add in own organisations content. Added in suboptimal care format (to align with AWARE™ and ALERT™) why are you here? New BEACH™ Systematic Assessment Framework tool. Added in accountability and delegation and roles/responsabilities as a unregistered healthcare staff, followed with a case study which demonstrates both accountability and human factors. Sepsis added as mandatory content. Scenarios to remain in each element Airway, Breathing etc. AKI and fluid balance added to Circulation element. Prioritisation exercise to remain. Record keeping and accurate documentation added throughout content.

Example of a full day BEACH™V2 programme Suggested minimum timings (can be extended) Topic Essential Content ESTIMATED TIME   09.00 - 09.15 Welcome and Introduction Setting the Scene, why are you here? Suboptimal care – Why are you here at the BEACH™? Yes 15 minutes 09.15 - 09.45 BEACH™ Systematic Assessment Framework (local NEWS & Escalation) 30 minutes 09.45 – 10.15 Accountability, Delegation & Documentation – Your scope of practice 10.15 – 10.30 BREAK 10.30-11.15 Airway Assessment and Alertness 45 minutes 11.15 – 11.45 Breathing Assessment 11.45 – 12.30 Circulation Assessment & Disability (Including fluid balance and AKI) 12.30-12.50 Sepsis

Example of a full day BEACH™V2 programme   12.50 -13.30 LUNCH 40 minutes 13.30 -14.30 Handover, escalation & communication tool (SBAR) Human Factors Case Study (Table top exercise) Yes 60 minutes 14.30 -15.30 (Split into 3 groups of 4 candidates) Table Top workshops – Patient Scenarios Scenario A Scenario B Scenario C 15.30-16.00 Evaluation and Close – ROL & Evidence based future practice with BEACH™ workbook 30minutes In full day course a module which organisations can do to extend to a full day is the scenarios. X 4 generic scenarios written which relate to scenarios from manual. Similar structure to ALERT™ V4 course. Designed to be only 10 minute in length.

Scenario A (Airway) : Airway Obstruction History for candidate:   B A R You are about to complete routine care on a patient when you hear the patient is snoring and appears pale and sleepy. The patient is in hospital having had a TIA (Transient ischemic attack). The patient is not responding to you and you can hear snoring which is not normal for the patient. What are your next steps? Do you need help now? NEWS score: 12   LOOK, LISTEN and FEEL Assessment of patient – what you find What assessments do you make in look, listen & feel? Airway The patient is not responding to you when you talk to them. Patient is sat up slightly but slumped to the right hand side. Look: Listen: Feel: ACTIONS: Example of how a BEACH™ scenario will look. Similar in structure to ALERT™ v4. This can be done as a table-top exercise for all candidates to work in small groups on their tables and complete the scenarios with actions, next steps, escalation and handover. Can then report back to the rest of the group with facilitator notes added. Main message for these scenarios is the ability for the unregistered healthcare staff to recognise a problem, call for help/escalate early and intervene appropriately (within scope of practice). Flexibility to stretch learners (if within scope of practice) facilitator dependant (Like ALERT™).

Example of BEACH™ record of Learning Print Full Name: Date of BEACH™ course:   Achieved on the BEACH™ Course Application of learning in clinical practice Reflection by the individual on use in clinical practice Communication and Handover Care Certificate Standards met: Work in a person centred way (5) Communication (6), Handling Information (14) Initials of BEACH™ course facilitator Initials of Supervisor or Self-Assessment and Date Recognises when help is required and calls them promptly to ensure help arrives in a timely manner Able to use a structured communication tool (SBAR or RSVP) to handover a patient to a more senior member of staff Demonstrates good communication skills with the patient so they are kept informed Demonstrates good communication skills with the patient by explanation of actions and any assessments made Recognition and Management of the acutely ill patient Care certificate standards met: Understanding your role (1), Your personal development (2), Duty of Care (4), Work in a person centred way (5), Handling information (14) Uses an Airway (A), Breathing (B), Circulation (C), Disability (D), Glucose (DEFG) and Handover (H) approach to assessing a patient who is acutely unwell Understands a ‘Look, Listen & Feel’ approach when assessing patients

Questions?

Summary Overview of the last year at ALERT™ HQ and development ideas for BEACH™ V2. Ideas for new programme structure for BEACH™ V2

Quality Assurance All ALERT™ Centres asked to complete one set of candidate evaluations per year. April- June July-September October- December January –March Evaluation Form from Management system – to be given to candidates http://www.smartsurvey.co.uk/s/pht_ontheday_alert/

Human Factors Revamp What works? What doesn’t? Resources