1. Emergency Information Files In RHSC anaesthetic rooms John Glen ST3

2. Introduction Emergency Information –Flipboards –Wallcharts Feeling that current system could be improved Casual inspection confirms this

5. How to audit? Lack of explicit criteria RCOA –List of essential files –Essential files in place –No ‘extra’ files –Means of identifying/rectifying deficiency –Mechanism for updating

6. Initial Audit Sweep March 2009 9 areas Heterogeneity: –27 document types –Range of 4 to 15 documents per location –Median 11

7. Initial audit sweep Problems: –Out of date files –Missing files –Inappropriate files

8. Results

9. Red = Outdated

10. Red = Inappropriate

11. ‘Inappropriate’ Newton Valve cleaning Theatre Booking ADE valve MRSA circular Controlled drug circular

12. X = Missing 1 2 3 4 5 6 7 8 9 xxx x xx xxx x x xx

13. ‘Essential’ Files Advanced Life Support algorithm Anaphylaxis Local Anaesthetic Toxicity Child Protection Malignant Hyperthermia

14. 1 2 3 4 5 6 7 8 9

15. Improvement Phase Generate List Put files in place Mechanism for maintenance

16. List of essential files By ‘consensus’ List too large Flowcharts in suspension files Booklets etc. in folder

28. ‘Folder Items’ Trainee Handbook Guidelines for: –Pain, blood, asthma, endocarditis, latex, hickman line access Full child protection booklet

29. Improvement Phase Files now in place Identical layout in all anaesthetic rooms Master file kept separately Consultant will be ongoing ‘lead’ Plan for regular review

30. Future Project Roll out scheme to other areas –Cardiology, CT, recovery –?A&E, ?ITU Decide what should be on wall

31. Worthwhile? Access to emergency info crucial –Anaesthesia –Paediatrics Rotating trainees –Unfamiliar with paediatrics –Unfamiliar with hospital Useful resource

32. Discussion Are you surprised at the initial results? Are these files a good idea? What should be in them?