1. National Leadership and Innovation Agency For Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd National Leadership and Innovation Agency For Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd A & E Snap-shot Audit 2005 Swansea NHS Trust Change Agent Team

2. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Background Commissioned by Welsh Assembly Government In response to perceived increases in A & E attendance (Nov ’04 – Feb ’05) Complementing WECAC Programme Toward better understanding to inform future investigation

3. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Aim: To produce quick and clean evidence to support a brief view of: 1.Why patients presented at A & E? 2.Whom did they contact in the management of their A & E presenting problem? The key element of the audit was to focus on the ‘patient perspective’

4. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Who carried out the audit? National Leadership and Innovation Agency for healthcare Aimed at building leadership capacity and capability to deliver continuous service improvement, optimising technology, innovation and the implementation of leading-edge practice. Change Agent Team Purpose is to support sustainable change by working with whole systems

5. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd What did we do? Undertook two 24 hour audits (Sunday/Monday and Tuesday/Wednesday) Used a specifically developed patient questionnaire Interviewer recorded individual respondent answers for TRIAGE category 4 or 5 patients only Collated and analysed data collected Provided report and individual feedback to relevant organisations

6. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Organisations involved in audit: Welsh Assembly Government Change Team WECAC National Team University Hospital Wales, Cardiff. Morriston Hospital, Swansea. Princess of Wales Hospital, Bridgend

7. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd When was the audit carried out? From 10pm Tuesday 19 th April to 10pm Wednesday 20 th 2005 & From 10pm Sunday 15 th May to 10pm Monday 16 th May 2005

8. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd How many patients were interviewed? Total over 48 hours: 318 Tues/Wed period: 145 out of possible total 188 attendees Sun/Mon period: 173 out of possible total 215 attendees

9. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Who attended?

10. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Why did they attend?

11. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Patient Rationale - Tues/Wed

12. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Patient Rationale – Sun/Mon

13. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Whom did they contact prior to A & E?

14. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Key findings and next steps Findings: Different days similar trends (age, problems) Patients had taken action based on known facts and experience (contacts, rationales) Next steps: Provide formative report to Minister Provide summative report to sites Produce Patient Perception tool

15. ©National Leadership and Innovation Agency for Healthcare Asiantaeth Genedlaethol Arweiniad ac Arloesoldeb dros Ofal Iechyd Change Agent Team Lynda.chandler@nliah.wales.nhs.uk Paula.martyn@nliah.wales.nhs.uk Breeda.worthington@nliah.wales.nhs.uk