Critical Care Operational Delivery Networks

England, Wales & Northern Ireland

NoECCN Outreach Group Meeting

25th February 201614:00- 16:00hrs

Room 6, Northumbria Specialist Emergency Hospital

Present: Lesley Durham, Julie Platten, Rob Duncan, Peter Smith, Diane Miller, Sarah Gray

Chair: Lesley Durham
Minutes: Sarah Gray / Attachments
1. / Apologies
Isabel Gonzalez, Jon Walton, Michael White, Jane Atherton, John Lewandowski, Lindsay Garcia
2. / Welcome and introductions
LD welcomed and thanked all for attendingthe meeting.
3. / Minutes of last meeting and action points
Minutes agreed as a true and accurate record.
Action Points:
4. NEWS - The North East Urgent & Emergency Care Vanguard Programme is to start a 5 year programme introducing NEWS into all nursing and residential care homes. This will build on the successful pilot work already undertaken in the Sunderland area.The RCP NEWS will be the assessment and communication tool throughout the patient pathway. Colleagues in organisations who are not yet using NEWS or who are using a local variant are asked to bring this to appropriate attention – particularly A&E’s where patients will present.
12. Outreach audits – Please send a list of all audits to JM
Diane Miller agreed to share list of ongoing audits being completed at STDH.
4. / NoECCN/National Update
NoECCN
Funding: The Network has received confirmation of funding for another year.
Critical Care Transfers: The process for requesting a critical care transfer has changed (NEAS).Younow request an R1 not G2 and you do not have to give a 30 min pre booking call (this was originally introduced when there were only certain ambulances that could take the critical care trolley – now all ambulances are compatible). Transfer Guidelines have been amended accordingly.
Query regarding consumables for the transfer trolley - attached including details for the straps for bariatric patients’
National
NEWS – LDhas not received final communication from RCP with regard to the final version of v2 NEWS.
Sepsis – 3 published
qSOFA discussed (as an attachment) /

5. / Level of Care Point Prevalence Survey2016:
Preliminary results:
All Trusts participated except CDDFT
Total of 4732 patients
Level 0 – 62.63%
Level 1 – 32.84%
Level 2 – 2.68%
82 within critical care unit and 45 outside of critical care. 43 patients outside of critical care were all deemed to be in an appropriate environment e.g.) Respiratory unit / coronary care / delivery suite ….. but….staffing levels / skills sets often a challenge in these areas – therefore a ‘risk’. 2 patients were being identified as being in the ‘wrong’ place.
The report once finalised will be sent to the NoECCN Stakeholder Board, CEO’s and Commissioners.
LoC – 2017
The group agreed to carry out the LoC audit on Tuesday 7th February 2017.
For the 2017 audit it was agreed to add prevalence of active (Treatment escalation plans (TEPs). Peter Smith to share the revised TEPS form used at Northumbria (if wishing to replicate or devise something similar, please contact Peter or Karen Connelly). (attached)
LD requested sight of all other TEPs being used within the network please. /

6. / NoECCN Patient Satisfaction Survey 2015
157 have been completed.
LD to produce an abstract on behalf of the outreach group for NOrF Conference in Belfast on 6th May ‘Critical Care Outreach Teams Help Patients’ Feel Safe and Reassured’(attached). LD gave particular thanks to PS, RD, DM and JM for their help with the thematic analysis of comments.
All agreed that this has proven to be a very insightful and useful survey despite some initial reservations. It was suggested that LD share the final poster / report with Trust patient experience leads.
It was suggested to look at undertaking a survey of relative opinion / satisfaction of Outreach later on in the year. All were asked to consider questions / quality statements for this in preparation for the next meeting. /
7. / METHOD 2 Study
LD asked who hadparticipated in this.
SRH, NSECH had both signed up. STDH had issues with the audit department. After discussions the group felt that the timeline from announcement and completion was verychallenging in relation to securing R&D approval. On behalf of the Network LD to feedback to the study investigators.
8. / Outreach Activity Data (NOrF DataSet)
LD thanked those teams who submit this on a monthly basis - but this is not received from everyone. The Network is unable to analyse the data due to the lack teams submitting the data. Outreach Team leads were kindly asked to identify 2 champions to take responsibility for data collection and submission.
LD will ask IG to put the data fields into a ‘survey monkey’ as this may help with the ease of submission and Network wide analysis.
JP agreed to re-launch with a mini-workshop at the next meeting.
9. / Level 1 Competencies
Building on the work of the National Critical Care competencies, CC3N are to approach NOrF with a view to develop a set of ‘Level 1’ competencies for ward based staff. The group were asked to consider what these may include. Anyone interested in this work to advise LD.
10. / Cardiac Arrest Audit
JP brought to the attention of the group the ‘Prevention, Detection and Rescue of Deteriorating Patients. Which combinations of interventions are most effective’ - an NIHR funded study. All agreed that it was not an easy question to answer.
11. / Trache Guidelines Trial Newcastle Hospitals
Feedback from Ingrid O’Neil - Deferred to next meeting
12. / Individual Updates
NSECH
Northumbria hasapproved a business case to provide Outreach 7 days a week (8-8) across all 3 sites.
Currently implementing WIMS – an electronic patient record.
SRH
With regards to service delivery, no changes. Ensuring succession planning by rotating band 6’s from the unit though Outreach. Last year process and outcome data presented to Trust Board – was received very well. May be of interest group / NoECCN Conference. RD happy to share at next meeting.
STDH
Now have 8 in the team. Started running an ‘Outreach Study Day’ which has received very good feedback. DM to send the programme (attached).
T4T: Have ran 2 successful in- house study days .Names have been submitted for the NoECCN ‘Train the Trainers’(TtT) study day. /
13. / CCOrC
Dates for 2016 have not yet been confirmed – apologies for this. LD /IG will advise ASAP.
Please forward names to LD of interested staff wishing to complete CCOrC.
The updated manual is currently being editing. DM asked for those who have previously undertaken CCOrC and who help supervise new students if they can have access to the new manual in order to keep up to date. LD thought this was a reasonable and sensible request and will investigate and feedback.
CCOrC has been recently been assessed by Northumbria University (Oct 2015) and received high praise. The academic quality of the CCOrC equates to the expectation of the University and successful completion of CCOrC will be accredited (40 level 6 or 7 credits) through a number of routes in the continuing development framework such as the accreditation of work based learning module (AWBL) or recognition of continuing professional development (CPD) module.
LD will continue to pursue the equivalent status at Teesside University.
14. / NoECCN Conference
NoECCN conference – 12th October. Feedback from last year’s conference suggested inclusion of an ‘Outreach section’. LD asked if anyone like to give a 10 minute presentation on established outreach services, innovations and advances made.
Date and time of Next meetings:
21stJune Room 23/24 Education Centre UHNT 14:00-16:00
18th October Room 4 NSECH 14:00-16:00
Actions Agreed / WHO / WHEN
1 / Colleagues in organisations who are not yet using NEWS or who are using a local variant are asked to bring this to appropriate attention – particularly A&E’s where patients will present. / Those it concerns / ASAP
2 / List of all outreach audits to JM / All / ASAP
3 / List of on-going audits at STDH. / DM / ASAP
4 / Final LoC 2016 report to be sent to the ODN Board, CEO’s and Commissioners. / LD / When complete
5 / Northumbria Treatment Escalation Plans (TEP) to be shared with the group / PS / KC / Attached
6 / Share all TEPs being used within the Network / All / ASAP
7 / Submission of abstract of patient survey on behalf of the outreach group to NOrF for conference in Belfast on 6th May 2016 / LD / 18/03/2016
(attached)
8 / Circulate ‘Outreach Patient Satisfaction Survey’ final poster /report to Trust patient experience leads / LD / When complete
9 / Consider questions / quality statements for survey of relative opinion / satisfaction survey of Outreach services / All / 14/06/2016
10 / Feedback to METHOD 2 study investigators – tight time lines / LD / May 2016
11 / Outreach Team leads to identify 2 champions to take responsibility in data collection and submission. / Outreach Leads / ASAP
12 / Create a ‘survey monkey’ for NOrF Data set submissions / IG / 14/06/2016
13 / NoECCN Outreach activity (NOrF data set) re-launch / workshop / JP / 21/06/2016
14 / Development of ‘Level 1’ competencies for ward based staff. Anyone interested in this work to advise LD / All / ASAP
15 / Trache Guidelines Trial Newcastle Hospitals / IO’N / 21/06/2016
16 / Overview of Sunderland Outreach ‘ process and outcome data’ / RD / 21/06/2016
17 / Programme for Outreach Study Day at STDH to circulate with the minutes. / DM / Attached
18 / Dates for CCOrC 2016 / IG/LD / ASAP
19 / Forward names to LD of interested staff wishing to undertake CCOrC / All / ASAP
20 / Access to updated CCOrC manual for those who have previously undertaken CCOrC and who help supervise new students. / LD / IG / ASAP
21 / Continue to pursue the equivalent AWBL status for CCOrC at Teesside University / LD/ IG / ASAP
22 / Suggestions / volunteers to present at NoECCN conference / All / ASAP

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