Rapid access to speciaist advice and review for GP's, NN, NNNP's
When patients are unwell and the GP is contemplating admission to ED, having access to rapid speciaist advice or review may prevent a hosptial admission.
Patient presents with respiratory issues, rapid access to respiratory advice/ review may prevent the need for admission. Eg patient may not need admission just uptitration of current medical regime for a few days.
Patients that present with cardiac issues, rapid access to cardiac advice/ review may prevent the need for admmission. ECG flash project is an example of this. It is currently set up for rural and remote areas but could easily be expanded to urban settings. ECG is sent to a Cardiologists phone or ipad and the Cardiologist responds within 10mins. This is not meant to be for crital STEMI patients they need to come to hosptial.
If patients are well know to services decision can often be made very quickly rather than a patient enduring a lengthy ED asessment.
Outpatient services need to be more flexilbe particularly when a patient needs semi urgent review. It is really difficult to get rapid access and ED presentations are often the default in these situations.
SCaNNR (predictive) data may be useful to guide this processes- linked public hosptial, ED, ESWL and dealth registry. Including Morbidity data, hosptial utilisation data and Geograghical demographic/socio Demographic data. (this data is produced by the Qhealth data and statistics branch). These number may be useful in identifing number of rapid access required.
Ed data would need to guide this process eg most frequent presentation (DRG's). Nursing corordination of this is essential. The most vunerable patients and the frequent presenter often require suppoort and co-ordination to attend appointments etc.
Why the contribution is important
Access to specialist services for advice or review from the community is a very disconnected, inflexible and often a laborious process. This disconnect often leads to emergengy department presentations as a default. The time periods immnediately after discarge from hosptial or just before presentations are crital touch points in a patients journey. Rapid acess to GP's Nurses and Specialists within these time periods is critical if we are going to influence a reduction in ED presentation and ED representation. Eg Better cardiac care program for A&TSI people has almost havled the 28 day readmission rate just by making sure the patient sees a GP within 7 days from hosptial discharge.
by VivianBryce on August 20, 2019 at 12:36PM