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E is for Emergency Department Safety Checklist

E is for ED Safety Checklist

Our Emergency Department Collaborative was set up in August 2016 to encourage greater collaboration between each of the six acute trust emergency departments (EDs) across the West of England, as well as the South Western Ambulance Service.

One of the collaborative’s key areas of work has been the implementation of the Emergency Department Safety Checklist (developed by University Hospitals Bristol NHS Foundation Trust) across five of the six acute trusts.

To support the roll-out of the ED Safety Checklist across the region (and hopefully beyond), we have developed an ED Safety Checklist toolkit, which you can download here.

The aims of the Emergency Department (ED) Safety Checklist are to standardise and improve the delivery of basic care in EDs, to improve resilience in EDs during periods of crowding, to improve the safety and clinical outcomes for patients accessing the emergency care system, and to improve ED performance against Best Practice Tariffs.

What is the ED Safety Checklist?

An ED Safety Checklist is a time based framework of tasks that is completed for every patient, other than those with minor complaints. The ED Safety Checklist can be completed by any member of clinical staff in any area. It is prescriptive and contains all basic elements of care. Best Practice Tariffs and early triggers to specific care pathways such as sepsis are included.

What is the problem we are trying to address?

Crowding has a profound impact on the ED’s ability to deliver safe care.

Delays in recognition and treatment of severe illness are common, with associated poor outcomes.

This is particularly problematic for patients suffering from stroke, heart attack and sepsis.

A scarcity of staff in the ED workforce has resulted in a reliance on agency and non ED-trained staff.

Human factors – as staff become overwhelmed by the tasks they need to complete in a timely fashion and with constant interruption.

What is the evidence base for the intervention?

At University Hospitals Bristol NHS Foundation Trust (UH Bristol) the mean proportions in Key Performance Indicators (KPI) taken before and after the introduction of the ED Safety Checklist improved in 5%-25% in most cases.

Quality improvements we hope to achieve:

  • Improved baseline clinical care
  • Less clinical incidents
  • More efficient handover
  • More efficient documentation
  • Improved performance against best practice tariff
  • Decrease avoidable harm by recognising deterioration
  • Enhanced safety region-wide
  • Improved communication
  • Improved team morale
  • Improved patient and staff feedback.