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Emergency Department (ED) Access, Patient & Staff Safety Huddles

This document provides a summary of best practice in relation to ED access, patient and staff safety huddles. The summary has been created to support staff during the Sunshine Hospital Emergency Department Redevelopment transition and early post-move period, and has been endorsed by the ED Leadership Team.

Overview:

This QRG aims to provide Emergency Department staff with an overview of the ED Access, Patient & Staff Safety huddle processes.

The ED Access, Patient & Staff Safety huddles aim to highlight and address areas of concern in the ED that impacts patient flow, access to care, patient and staff safety.

The ED Access, Patient & Staff Safety huddles brings together a multi—disciplinary team, to problem solve against the issues of the moment within each department. These huddles are to be collaborative with a focus on problem-solving, and the development of actions that achieve better patient care outcomes.

Applicability:

This QRG applies to staff working in all WH Emergency Departments as well as other stakeholders identified in the huddle framework.

Responsibility:

It is the responsibility of the ED NUM’s and Medical Directors to ensure all relevant staff are appropriately orientated and educated to the content of this QRG and their respective responsibilities

Guideline/Process Details:

Daily Huddle times:

Campus

Times

Sunshine 0830, 1200, 1600 & 2200
Footscray 0830, 1400 & 2030
Williamstown 0800, 1500

 

Attendees Include:

Footscray Sunshine Williamstown
·         ED&SSU MO I/C

·         ED&SSU NIC

·         AHA/Access Manager

·         ACE Representative

·         EMH Representative

·         ED&SSU NIC

·         ED&SSU MO I/C

·         Paed MO I/C

·         PSA Supervisor/I/C

·         AHA/Access Manager

·         ACE representative,

·         EMH representative

·         ED NIC

·         ED MO

·         AHA/Access Manager

 

Huddle, principles, purpose and particulars:

  1. The meetings involve the sharing of statistics and status indicators. These aim to promote conversation about the current state of the department.
  2. The meetings collect data against the four operational domains;
    1. Quality and Safety
    2. Access and Flow
    3. Staffing/Workforce
    4. Environment

The huddles are to focus on the combination of issues from each area and any impact of patient and staff safety.

  1. Huddles are coordinated by either the ED NIC or ED EP/MO I/C for that shift
  2. Meetings conclude by asking staff to nominate three actions that will be taken to addresses issues that have been identified during the huddle.
  3. Actions identified in previous huddle are discussed regarding resolution / outcomes / impact on current figures and step 1 through 5 repeated.
  4. ED NIC responsible to take a photo of huddle board after last huddle of the day and store in NIC Mobile phone

 

Supporting Documents

Access Management in the SHED QRG

Ambulance Victoria Arrivals – Patient Flow Processes QRG

Patient Streaming – SHED QRG

 

Governance Table

Title: Emergency Department (ED) Access, Patient & Staff Safety Huddles
Version: 1.0
Date Published: February, 2021
Date of scheduled review: February, 2022
Author:  Approver: 
ED Leadership Team ED Leadership Team

Appendix

Appendix 1 - NIC stat cheat sheet for huddles – ED & SSU

NEAT
SSU NEAT
HOME NEAT
BED REQUEST NEAT
AV OFFLOAD
INPATIENT LOAD
NUMBER OF INPATIENTS
LONGEST INPATIENT LOS
BEDS ALLOCATED/READY
SSU
PATIENTS IN SSU
SSU PENDING
ED DEMAND
WAITING
WAITING ABOVE 2 HOURS
AV RAMPED ABOVE 40 MINUTES

 

MENTAL HEALTH
NUMBER INVOL/VOL
NUMBER WAITING ASSESSMENT

Appendix 2 - Example FED Access Huddle Board

Appendix 3 - Example SHED Access Huddle Board

Appendix 4 - Huddle Lead Script

HUDDLE LEAD SCRIPT
PERFORMANCE TRACKER
·         Is there anything we can reflect on regarding yesterday’s performance?
LOOKING FORWARD
·         How is staffing?

 

> If vacancies, are they filled? YES/NO

> If unfilled, is this

a) not required

b) advertised

c) unable

 

·         What is our inpatient demand?
·         What is our SSU demand?
·         What is our ED demand?
·         What is the hospital bed availability?
·         What is our mental health demand?

·         Any restraint use?

·         Is there any clinical risk?
·         Are there any equipment, IT or environmental issues?
·         Anything else to mention?
ISSUES LOG
·         Are there any outstanding issues that need resolution?
OVERALL STATUS
·         Where are our pressure points?

o    Staff

o    Service

o    Standards

o    Environment

Refer to escalation criteria
ESCALATION DETAILS
·         Are there any issues that require escalation?
ACTIONS
·         How do we address domains with amber and red status?
·         How can we best meet demand right now?
·         Should we ask for help to fix something?             > Yes – escalate via Huddle Text
·         Does anything need an FYI to management?       > Yes – notify via Huddle Text

Appendix 5 – Mental Health Escalation Process

Appendix 6 - FED - Escalation and Action Framework

Appendix 7 - SHED Escalation and Action Framework