G230(P) Can utilising out-patients space improve services offered in a ped?. (25th October 2020)

• Record Type: Journal Article
• Authors: Mullen, S; Oman, T; Dalzell, E; Fitzsimons, A; Bartholome, B; Jahn, H
• Is Part Of: Archives of disease in childhood. Volume 105(2020)Supplement 1
• Page Start: A83
• Page End: A83
• Publication Date: 2020-10-25
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-rcpch.197
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: The PED that has seen a 10 000 increase in attendances over the last 5 years with no increase in space to accommodate this. This led to issues with patient flow, poor morale and increase in waiting times. Our aim was to utilise out-patient clinic space to run a minor illness and injury area for emergency department attendances. Methods: This initiative utilised fracture out-patient clinic and staffing with middle grade paediatric or emergency staff. In addition, this service was staffed by a band 3 receptionist, an enhanced nurse practitioner and a band 5 nurse. The clinic runs on the three peak days of the week (Monday, Tuesday and Friday) between 17:30 to 22:30. Results: 404 patients were seen over 31-days, averaging 13 patients per day. A survey was completed by 52 patients/parents. 98% reported that this was an appropriate area to be seen with another 98% stating that the Winter pressures clinic was beneficial. They rated there experience as 4.1 out of 5 (mean). Comparison between this year (2018/9) and previous (2017/8) demonstrated a reduction in average time in ED of 11 minutes per patient for all category four and five patients despite significantly higher numbers. The comments from parents supported the use of this initiative; 'A +E was a nightmare, overcrowded and not a nice environment. Minor unit is quiet and less stressful for the baby and parent ', ' Getting moved to the other emergency department today was for the better' . Staff have been very supportive of this service. Comments acknowledged the ability to provide a more efficient service to those of a lower triage category. The service was also found to be beneficial to the higher acuity patients in the ED allowing them to be allocated to a treatment room quicker and prioritising staff to see them in a more efficient and timely manner. Conclusion: The use of an out-patient clinical space is an appropriate area to manage minor illness and injury in the emergency department. It has improved flow, reduced waiting times and is acceptable area for patients and staff.