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HEAT T10

HEAT T10. Mr David Chung Clinical Director, Emergency Medicine Ayrshire and Arran. Targets. The Good “the 4 hour target”. Targets. The bad 5 Year plans Great Leap Forward HEAT H5? HEAT H4?. Targets. The Ugly Vietnam War “War on drugs” Credit Crunch. Targets or Goals?.

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HEAT T10

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  1. HEAT T10 Mr David Chung Clinical Director, Emergency Medicine Ayrshire and Arran

  2. Targets • The Good “the 4 hour target”

  3. Targets • The bad • 5 Year plans • Great Leap Forward • HEAT H5? • HEAT H4?

  4. Targets • The Ugly • Vietnam War • “War on drugs” • Credit Crunch

  5. Targets or Goals?

  6. Emergency Medicine • Provide care to undifferentiated self presenting patients, 24/7/365 • No exclusions

  7. What is unscheduled care • If you can appoint, isn’t that planned?

  8. ED Access Decide need Get there Book in

  9. Phone Someone Decide Need Appointed Wait Transport Book in

  10. We are not contracted to provide care for minor injuries. If you have an injury please go the Accident Infirmary at the Victoria Infirmary.

  11. Back to HEAT T10 • What has this got to do with Emergency Medicine?

  12. Role of Emergency Medicine • To gather information • To direct this to someone who can do something with it, possibly with advice • To develop redirection pathways

  13. Story so far • Information • Demographics of attendees • Analysis of attendance to identify possible redirection

  14. Demographic stuff • Stewart Cardwell’s analysis of Ayrshire attendances • 17-35 year olds make up 25.5% of workload • Of 79% are self presenters or 999 • Only 20% get admitted, 40% are discharged without review

  15. Analysis • Casenote review of 1733 patients, about 5-10% of out of hours attendances should be primary care • 2.5% attendances are psychiatric

  16. Redirection pathways • Currently: • Go to A&E • For the future; • Back to relevant community based care

  17. Potential progress • Front door redesign • Re direction • Cross fertilisation

  18. Changing behaviour • Futile unless experiential learning • Advantages clearly demonstrated • Sanctions applied

  19. Comments

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