Hospital at Night StAZ Study Trip 18 January 2009 Tim Lund Divisional Manager Skills for Health Workforce Projects Team

Hospital at Night Multi-disciplinary team working: right person, risk skills, right place, right time 2003 – 2005: Piloted and evaluated. National support in partnership with the London Deanery 2008 Survey: three quarters of trusts report having services The “Case for Hospital at Night: the Search for Evidence” demonstrated improved patient safety

Hospital at Night Update More evidence of Hospital at Night teams improving patient care Observational study at Edinburgh Royal Infirmary for 14 nights before and after implementing found that: - Patients were reviewed more frequently by senior medical staff - Significant inter-specialty differences in response times eradicated - Reduction in adverse patient outcomes from 17% to 6% (Defined as unplanned transfer to critical/cardiac arrest in the 18 medical/surgical wards and the Combined Assessment Unit) Source: QJ Med 2009; 102: Author Dr D.J. Beckett et al

Hospital at Night and 24/7 Bid for longer term study focussing on patient safety. Partners: Imperial, London Deanery, Royal Colleges, I.C. Targeted consultancy support to trusts still trying to establish Indications - 24/7 solutions and hot & cold split/team work support the quality of patient care and can sustain training

introduced introduced National average HSMR Data at Guy’s and St Thomas’:

Confidence in and 24/7 Longevity 24:7 solutions appear sustainable at Homerton, Guy’s & Tommy’s, South Devon & Royal Liverpool & Broadgreen Award winning solutions in place for about two years Consistent with Quality and Productivity agenda Wide support from stakeholders for quality solutions

Development of Tools / Support system implemented in small number of trusts Robust handover systems available. We are sponsoring Salisbury to roll out handover tool to 20 trusts 12 hour e-learning course under development with London Deanery & DH. Core skills and curricula Opportunity for blended learning. Sustaining training vital

Particular Value of Simulators Full immersion Complex multi and inter-professional working Particularly when linked to effective behavioural debriefing Source: London Deanery

Particular Value of Simulators Full immersion Complex multi and inter-professional working Particularly when linked to effective behavioural debriefing Source: London Deanery

With support from

Salisbury Handover Tool Multi-professional tool sponsored by Workforce Projects Team Designed by clinicians & developed by the users at all levels to ensure maximum utility Meets info governance and data protection requirements Provides a focus for handover. Handover list accessible across hospital by appropriate staff can be updated real-time! Source: Salisbury

Hospital at Night List Linked to Consultant List or can stand alone Correct patient details Management plan detailed Reason for involvement Priority for review Accessed throughout the day Printed for team Auditable Source: Salisbury

Helping to Make EWTD Manageable

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