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Improving Out of Hours Care in Hospitals

Dr Kause's speaks at today's conferenceDr Kause's speaks at today's conference

Today's conference focuses on out of hours care in hospitals and moving towards delivering high quality safe care at night.

Conference Chair Dr Juliane Kause Specialist in Critical Care and Acute Medicine University Hospital Southampton Foundation NHS Trust opens the conference with an important update on 'Towards the 24/7 Hospital'.

Dr Kause discusses the UHS Staff survey: 

"UHS conducted a Staff survey.  It was sent to Medical Staff, local leaders, clinical staff & Corporate managers"

"Survey method - The three agreed elements of the work were collaborative design, development, conduction and analysis of:
Bespoke inpatient feedback survey 
Independent staff, patient and stakeholder interviews
Stakeholder workshops as part of a regional RCP accredited Out of Hours and 7DS conference "

"Most clinically based staff's feedback was a lack of staff. New roles ahve been created:
First new job role created: Doctors administators have been appointed to keep all records up to date and conduct ward rounds and stock items. They also prepare discharge summaries.
Second job role - medical assistant who work 24 hours a day.
Thirdy - Acute care fellow."
om Giancarlo

Dr Kause's Biography:

Juliane Kause graduated from Charing Cross and Westminster Medical School in 1994. She trained in Acute and Critical Care Medicine and worked as a consultant in Intensive Care in Portsmouth before joining University Hospital Southampton NHS Foundation Trust in 2011. Since 2013, she has been the lead consultant for Out of Hours Care, leading delivery, development and research in out of hours inpatient care. University Hospital Southampton has been chosen as an early implementer of seven day services in March 2016 on the basis of all the improvements made through the out of hours programme.

Juliane is particularly interested in multiprofessional working to achieve best outcomes for patients, 24 hours a day, seven days a week, establishing an enhanced and sustainable Out of Hours service for inpatients.

Juliane is a founder member of the international Society for Rapid Response Systems, and contributes to the current national Seven Day Services programme. She has contributed to research and co-authored textbook chapters on acute physiological deterioration and rapid response systems in hospitals and is currently conducting research in Out of Hours Care Systems in collaboration with the University of Southampton.

Juliane is a founder member of the Internal Medical Examiner Group at University Hospital Southampton.

Her personal professional journey has led her to change career  from intensivist to extensivist.

The morning sessions continue with a presentation fr Laura Programme Manager at NHS England on '24/7 Services in Hospital: are we there yet?', covering

• implementing the updated 7 day services clinical standards 

• delivering the standards at night: are we there yet?

• the challenges: delivering consultant led care at night

Giancarlo comments:

"There's lots of data pointing towards the weekend effect.
These are the areas that improving out of hours servics will have: 

  • Better patient experience
  • Improved patient flow
  • Patient Safety
  • Better clinical supervision across the week

Progress is measured through a national self-assessment survey completed by all acute trusts every 6 months (Spring and Autumn)
The latest survery (Oct 16) showed that progress has been made but there are specifit issues with certain standards."

Pre conference abstract:

A substantial body of evidence exists which indicates significant variation in outcomes for patients admitted to hospitals in an emergency at the weekend across the NHS in England. This variation is seen in mortality rates, patient experience, length of hospital stay and re-admission rates. Additionally medical, nursing, other health professional and managerial staffing levels, as well as trainee doctors’ perceptions of supervision by consultants, also vary by day of the week.

To tackle this variation, the NHS is making sustained and comprehensive improvements to the quality of care at times when there has traditionally been a reduced consultant presence. These improvements are focused on the delivery of four priority seven day clinical standards, selected from a list of ten devised in 2013 by the NHS Services Seven Days a Week Forum. These standards cover time to first consultant review, timely access to diagnostics, access to consultant-directed interventions and ongoing consultant-directed reviews.

The ambition is for 25% of the population to receive hospital services that meet these standards by March 2017, building to 100% coverage by March 2020. Alongside this sits a related ambition for these four priority clinical standards to be met in five urgent network specialist services, specifically acute stroke, paediatric intensive care, STEMI heart attack centres, major trauma centres and emergency vascular services.

Giancarlo Laura's biography:

Giancarlo Laura is the Programme Manager for 7 Day Hospital Services at NHS England. He has been in this role since April this year. Prior to this, he spent 10 years at the Department of Health in a wide range of policy and briefing roles, including being the Department’s policy lead for end of life care and long-term conditions. His other roles at DH included running two junior Ministers’ offices for a number of years, which covered the 2010 General Election period. Before joining the Department, Giancarlo worked in Local Government, including the Greater London Authority, and in the private sector.

Click here to see Giancarlo's full presentation

Future conferences of interest:

Outstanding CQC Inspections in Hospitals
Monday 6 February 2017 
De Vere W1 Conference Centre

9 December 2016


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