1. 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.

2. 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

3. 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

4. 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.

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. Q&A