MTP2.11 Can an Advanced Clinical Practitioner (ACP) led Open Access (OA) Pathway provide a safety net for Emergency General Surgical (EGS) Patients?

Résumé fourni par la source

Abstract Aims Patients with uncomplicated treatable diagnoses rarely require routine follow up on discharge. If these patients deteriorate or have concerns, they re-present to their General Practitioner (GP) or Emergency Department (ED). We aimed to introduce an ACP led OA pathway via our Surgical Assessment Unit (SAU) to enable direct speciality advice, freeing up ED capacity and improving emergency flow. Methodology Multiple Plan, Do, Study, Act (PDSA) cycles were undertaken utilising GIRFT same day emergency care (SDEC) pathways to identify eligible patients. Patients fitting SAU inclusion criteria were given OA for 7 days via a dedicated ‘Consultant Connect’ telephone number. This phone was held by a member of the Surgical ACP team who could offer phone advice or arrange a formal review on SAU. Results 69 patients were given OA during the third PDSA cycle: 37 from ward discharges, 31 following SAU attendance and 1 from ED. n=23 (35%) phoned the OA line: 12 were given verbal advice, 6 reattended SAU, 4 were given next day appointments and 1 was directed to ED. 3 patients required re-admission. 34 inpatients were identified as being eligible for OA but were not offered this service. Conclusions OA can provide patients with a safety net which facilitates early discharge and prevents re-attendances to ED or GP services. Using ACPs to provide OA allows patients to contact a clinician with the knowledge and skills required to provide or coordinate virtual advice and assessment. Further work to ensure all eligible patients are offered this service is underway.

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