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821 / The implementation and the effect of an Emergency Response System

IRELAND
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Early warning
There is no specified text here There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
Our aim in introducing the Emergency Response System is that as an organisation we will recognise the early signs of a patient’s deterioration and ensure that medical assistance is provided at the pre defined trigger score.
We also provide the facility of an Emergency Response Team to respond to the immediate needs of a deteriorating patient 24 hours a day 7 days a week.
This should lead to a reduction in
•    Unplanned emergency admissions to the Intensive Care Unit.
•    A reduction in the number of in patient cardiac arrest calls.
•    A reduced hospital length of stay.
An overall reduction in the hospital mortality rate
Description of the Patient Safety Practice
 
Tallaght Hospital is a level 2 acute hospital providing 651 beds for adult and paediatric patients.
The Emergency Response System (ERS) is for the use of adult in patients as there is a paediatric version of the Early Warning Score (EWS) already in use.
The ERS comprises:
• EWS observation Chart
• The associated escalation protocol for the EWS
• ISBAR communication tool.
• The Emergency Response Team

A multi-disciplinary steering group was tasked with:
• Implementing the EWS in the organisation.
• Development of Tallaght Hospital Early Warning Scoring System observation chart.
• Introduction of a standardised communication tool. • Establish an ERT in Tallaght Hospital.
• Ensure the continued implementation of the EWS as per National Guidelines throughout the organisation & promote its use with all clinicians.

Education was provided for Nursing and Medical Staff and a phased roll out of the system began in January 2012. We implemented this Patient Safety Practice over an eight month period with full implementation to all inpatient areas in August 2012. We also educated and trained the Emergency Department (ED) in the use of the Emergency Response System and produced an ED specific escalation protocol. To date there have been over 150 Emergency Response Calls of which 60% have been treated at ward level and did not require admission to a higher level of care. Our inpatient cardiac arrest rate has reduced. We have seen a reduction in our mortality rate.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
No
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
No
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
201303201039481171_WP4_Data ERS.pptx
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Therapists
Clinical support
Administrative support (secretary, clerk, receptionist etc.)
Clinical manager
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Not known
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Involvement of service users did not happen
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Anne Marie Barnes
Country: IRELAND
Organisation: Tallaght Hospital
E-mail: Anne-Marie.Barnes@amnch.ie
Phone: 00 353 1 414 2123
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