Emergency Care Data Set (ECDS) Implementation tips for providers with TPP systems Emma Fernandez, ECDS Project Manager Rozanne Adams, Project Manager, NHS Digital Dr Dominic Hewitt, ED Consultant, Airedale General Hospital Shaun Milburn, General Manager, Airedale Tracey Mattock, ED Clerical Services Manager, Airedale Laura Jerwood, IT Clinical Systems Product Specialist, Airedale Shakeel Rashid, Senior Business Intelligence Developer, Airedale The ECDS project is a collaborative project between the Department of Health, the Royal College of Emergency Medicine, NHS England, NHS Digital, NHS Improvement, NHS Providers and Public Health England. This document has been produced on behalf of the ECDS Project Board in collaboration with the organisations listed above.

Before we start We’ve enabled “PC audio” so you can listen on your PC speakers as well as phone We are recording the webinar for the benefit of others The previous webinar links are available through the transcript document Please stay muted – please send your comments and questions via the WebEx chat function to Rozanne Addams We’ll be running a quick poll towards the end We’ll share the following after the meeting: The slides The links to the recordings The transcript of the QA session along with written answers

Running order Background on Airedale General Hospital A&E Start and running the webinar- Emma Fernandez Background on Airedale General Hospital A&E Our TPP system – Version used Our learning of implementing ECDS in a TPP system: Things that went well Things that did not go so well Mitigation of issues Where we are now QA

Airedale General Hospital ED Small DGH in rural West Yorkshire Covers approx 250k population Parts of 3 counties, with mix of rural and urban TPP A&E module used in ED, with Acute Hospital module elsewhere in hospital Currently using paper records, although EPR in development and “New consultation” now being used for review clinic entries.

Our learning- what went well 1/3 TPP provided a named link person for IT Explained and listened, e.g. “mark as suspected” Right people round the table Senior management Nursing Clerical/admin Information services IT CQUIN was important driver to ensure most important aspects addressed first

Our learning- what went well 2/3 Go-live a month before submission requirements began JDI Medical staff focused on content of coding Diagnosis- rather than symptom-based Improved GP letter content available

Our learning- what went well 3/3 Close liaison between Information Services and ED Clerical Services manager to ensure any gaps in data corrected ASAP Had to build some local operational reports to highlight any gaps. These reports were sent regularly to Tracey to monitor the CQUIN compliance and fix potential problems. Regularly improved the coding/inputting process System issues were also highlighted which TPP rectified

Our learning- what did not go well 1/2 No mop up yet Need opportunity to share lessons Doesn’t feel finished Too much manual configuration Investigation/diagnosis/treatment codes not pre-populated Unable to set up easily searchable lists Some ECDS codes don’t map to logical SNOMED code, so need to scrutinise (e.g. “Splint” maps to ”Thomas splint”) ECDS updates will need to be manually transcribed by IT

Our learning- what did not go well 2/2 Admin had to ask Drs to reduce coding If departure method and time completed on diagnosis tab, errors require patient to be rest tended, losing some data Big problem if no paper to fall back on Didn’t get everything we wanted Lost laterality of injury: ECDS decision, not TPP Presenting complaint vs chief complaint Failure of understanding ECDS intended nurses’ role, but initially left for reception Still not on department view

Mitigation of issues Close relationship and communication between Information and Clerical teams Lots of time for IT and Information Services to set up S1 and reporting outputs Not separately funded Fitted around other work streams Tweaking+++ Need information expert

Where we are now 1//2 Submitting data on weekly basis to SUS Current CQUIN position is 99% Some codes don’t map – specialty names have changed slightly in ECDS Codes still can’t be searched in a user friendly way Need to know what group a diagnosis is in before can search for it

Where we are now 2/2 GP letter (and reports) still don’t show “suspected” diagnosis code qualifier Chief complaint not available for GP letter or department management screen

Q&A