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AEC Presentation

The document summarizes an ambulatory emergency care service with the following key points: 1) It is led by Dr. Ash Sadighi and includes nurses, doctors, and other specialists to assist community and hospital services without requiring inpatient admission. 2) The service operates 8am-8pm Monday to Friday and on weekends to provide emergency medical care within 24 hours. 3) It receives referrals from various sources and handles common cases like cellulitis, DVT, pneumonia, and also runs specialty clinics and procedures. 4) The goal is to expand facilities and services over time to better manage emergency patients in an outpatient setting.

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wasim
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74 views17 pages

AEC Presentation

The document summarizes an ambulatory emergency care service with the following key points: 1) It is led by Dr. Ash Sadighi and includes nurses, doctors, and other specialists to assist community and hospital services without requiring inpatient admission. 2) The service operates 8am-8pm Monday to Friday and on weekends to provide emergency medical care within 24 hours. 3) It receives referrals from various sources and handles common cases like cellulitis, DVT, pneumonia, and also runs specialty clinics and procedures. 4) The goal is to expand facilities and services over time to better manage emergency patients in an outpatient setting.

Uploaded by

wasim
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Ambulatory Emergency Care

Clinical Lead: Dr Ash Sadighi


Team
• Admin
• Nursing
• Doctors
• Microbiologist
• HCA
• Pharmacist
• Porters
• Specialty input
AEC Aims and Objectives

• Assisting community services at the primary/secondary


care interface

• Providing emergency medical services within 24 hours


without the need for inpatient stay

• Support to specialist medical teams and A&E

• Facilitating in-patient discharges


Operational Information
• Open 8am – 8pm Mon to Fri
• Weekend 11am – 2pm (nurse led)
• Last patient accepted 5pm
• Telephone manned by Consultant / SpR
• Open for advice and discussion of referrals
• Fax referral or SystmOne
• Patient information available (template on SystmOne
and intranet)
• GP e consult and GP portal queries all answered by AEC
Consultant of the week
AEC referrals: 1 few months
st

• Urgent care centre

• Accident & Emergency

• Wards

• OPD
AEC referrals: Previous 12 months
Total Referral Sales
300

250
NHS
200 Hounslow
CCG
NHS
150 Total Re- Richmond
ferral CCG
NHS Ealing
100 CCG
Other
50

0
5

15

16
15
-1

v-

b-
g-
ay

No
Au

Fe
M
Discharge destinations
100%
90%
80%
70%
60%
50%
Home
40% Acute Ward
30%
20%
10%
0%
16
16

6
-1
b-
n-

ar
Ja

Fe

M
Examples of Some Common Cases

• Cellulitis • Rashes
• DVT • Pneumothorax
• PE (low risk) • Pneumonia
• Anaemia and • Pyelonephritis
transfusion • Fever in returning
• Osteomyelitis traveller
• Deranged LFTs • Headache
• Temporal Arteritis • AF
• Pleural effusion • Ascites needing
drainage
“Hot Clinics”
• Hot Clinics – 1 stop clinics. Seen by Consultant
or Registrar in Speciality. Usually 4-6 slots a
week.
• Endocrinology Hot Clinic – Tuesday pm
• Gastroenterology Hot Clinic – Tuesday am
• Rheumatology Hot Clinic – Thursday am
• Future plans – Care of Elderly, Thrombosis,
Neurology Hot Clinics
Work in progress
• AF pathway – now
operational

• OPAT (ICE referral)

• TA Pathway – now
operational

• Rapid Access Clinic for the


Elderly (RACE)/Neuro Hot
Clinic/Thrombosis Hot Clinic

• Heart Failure Pathway


Nurse Led Services

• Iron Infusion • Infliximab Infusion


• Blood Transfusion • Tocilizumab Infusion
• Hyperemesis • Rituximab
• Short Synacthen test • Venesection
• Dynamic Tests • IVIG
• Glucose Tolerance Test • INR
Examples of Procedures

• Pleural effusions
• Ascitic drains
• Chest drains
• Lumbar puncture
• Midline insertion
Future Plans
• AEC Expansion
• New facilities including procedure room
• Ultrasound guided procedures – now operational
• Long line insertions – now operational
• Pleurx drains
• Initiation of AEC shifts into F2 rotas – from August
2017
• Continue development of other specialty pathways
What the CQC thought…
• CQC feedback-“the AEC is effective in reducing the
number of inpatients and managing the increasing
number of patients who require emergency
admission following referral from a range of sources,
which include direct referrals from GPs.

• “The new AEC has made an impact on both A&E


performance and on reducing the number of
admissions. More importantly, patients we spoke to
were very positive about the care they received”.
What Patients Say
What Patients Say
Patient Journey

• Fax referrals collected first thing in the morning for


vetting by AEC team
• Patients will be added to the list and contacted
before 10 am
• On arrival, bloods will be sent and then Doctor’s r/v
• Every case will be discussed with AEC Consultant
• All decisions Consultant led – Consultant presence
8am-5pm Monday to Friday
• Patient discharged to GP, come back for F/U or
referred to other specialties

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