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NHS Borders Development of Escalation Policy. Dr. Simon Watkin Consultant Respiratory Physician Borders General Hospital simon.watkin@borders.scot.nhs.uk. Setting.

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nhs borders development of escalation policy

NHS BordersDevelopment of Escalation Policy

Dr. Simon Watkin

Consultant Respiratory Physician

Borders General Hospital

simon.watkin@borders.scot.nhs.uk

setting
Setting
  • NHS Borders Borders General Hospital Primary and Community Services Mental Health Social Services Scottish Ambulance Service Partnership forum
  • Population 106,500
  • 280 beds total
  • 102 GIM beds including 30 MAU and 12 HD
  • 30 DME, 30 stroke/palliative/community
why might you need an escalation plan
Why might you need an escalation plan?
  • 95+% bed occupancy
  • Delayed and cancelled surgery
  • 4 hour waiting breached
  • Medical boarders
  • Norovirus
  • Severe weather
  • Influenza
development of escalation policy
Development of Escalation Policy
  • Executive support
  • Large scale 1 day event
  • Small working group weekly
  • Agreed policy
  • Executive mandate
  • Implementation group
  • “Thin” policy document
  • Clear operational arrangements
who was involved
Who was involved?
  • AHPs
  • Bed Management
  • BGH Clinical Board
  • Borders Emergency Care Services
  • Borders Improvement Support Team
  • Communications Team
  • Community Hospital Superintendents
  • Discharge Liaison
  • Domestic and Portering Services
  • Infection Control
  • IM&T
  • Mental Health Clinical Board
  • PACS Clinical Board
  • Pharmacy
  • Planning and Performance
  • Public and Patient Representatives
  • Scottish Ambulance Service
  • Scottish Health Council
  • Social Work
  • Voluntary
timescale
Timescale
  • Concept April
  • Workshop June
  • Executive approval August
  • Implementation October
positives
Positives
  • Creative and innovative
  • Multi professional
  • Alignment of objectives
  • Better, safer treatment
  • Efficient
  • Cost effective
now what
Now what?
  • Implementation group
  • Data quality
  • Action cards
  • Patient flow action team
  • Monitoring
  • Trial period
  • Re-assess
  • Re-calibrate
how do we set the whole system status
How do we set the whole system status?

Red Red Red

Amber Red Red

Amber Amber Red

Green Red Red

Green Amber Red

Green Amber Amber

Green Green Red

Green Green Amber

Green Green Green

what s next
What’s next?
  • Have we got the thresholds correct
  • Can all groups react in real time
  • Will we learn anything we do not already know
  • Equitable spread of risk
  • Common understanding
slide16

"If you are too good at adjusting to the current system, you may never realise that the system needs changing“

Edward de Bono