Patients known as ‘High Impact Users’ (HIUs) attend our Emergency Department up to 80 times per year. Mental health problems, drug/alcohol use and homelessness account for almost all of the presentations, and the group has an average age of death in the thirties. The SHarED (Supporting High impact users to Emergency Departments) Project seeks to change this.
The SHarED Quality Improvement toolkit was originally created in March 2018 by the West of England AHSN in collaboration with the HIU team at University Hospitals Bristol NHS Foundation Trust (UH Bristol). This guide has been developed to support the implementation of the SHarED Project in local Emergency Departments.
The project is about supporting an innovative, system-wide approach that improves service user experience, supports staff, and reduces Emergency Departments attendances and hospital admissions.
The toolkit is based on the experience of the UH Bristol team in implementing a High Impact User Team in to the Emergency Department. The majority of resources available in this toolkit are made for immediate use; however they may require some adaptation to suit the local implementing site and have been designed accordingly.
The complete SHarED Implementation Guide
The SHarED Implementation Guide is designed to help local Emergency Department teams support high impact users. The complete guide is best for gaining an understanding of the project rather than using as working documents. For working documents see below.
* Please note, Domestic Violence has now been removed from the Driver Diagram on page 51 as this is no longer being prioritised as an outcome measure.
Working documents from the SHarED Implementation Guide
HIU Co-ordinator working documents
- Download HIU letter to GP to accompany proforma (32KB) >
- Download HIU patient worksheet (12KB) >
- Download HIU questionnaire for GP completion (30KB) >
- Download Cover letter to patient to accompany questionnaire (46KB) >
- Download Personal Support Plan template (52KB) >
- Download Cover letter to accompany Personal Support Plan to patient (34KB) >
- Download Questionnaire for patients with mental health issues (44KB) >
- Download Questionnaire for patients without mental health issues (46KB) >
- Download Bristol Emergency Department Impact Triage Tool (EDITT) (1.3MB) >
HIU Multidisciplinary Team (MDT) meeting documents
SHarED Quality Improvement Project
- Download HIU Staff poster 1 (50KB) >
- Download HIU Staff poster 2 (51KB) >
- Download HIU Staff poster 3 (48KB) >