Patient Electronic Alert to Key-worker System (PEAKS) Guidelines

Transcription

1 Patient Electronic Alert to Key-worker System (PEAKS) Guidelines This procedural document supersedes: PAT/EC 4 v.1 Guidelines for Patient Electronic Alert to Key-worker systems (PEAKS). Did you print this document yourself? The Trust discourages the retention of hard copies of policies and can only guarantee that the policy on the Trust website is the most up-to-date version. If, for exceptional reasons, you need to print a policy off, it is only valid for 24 hours. Name and title of author Lesley Barnett Lead Cancer Nurse Date revised December 2012 Approved by (Committee/Group) Cancer Management Team Date of approval 25 January 2013 Date issued 04 February 2013 Next review date December 2015 Target audience Trust-wide Page 1 of 7

2 Amendment Form PAT/EC 4 v.2 Version Date Brief Summary of Changes Author Version 2 December 2012 Added Acute Oncology CNS throughout. Item 4 - Removed last two bullet points as this proforma is no longer used. Appendix 1 revised and updated with new proforma. L Barnett Version 1 June 2010 Reviewed without change. L Barnett Version 1 July 2009 This is a new procedural document, please read in full. L Barnett Page 2 of 7

3 Patient Electronic Alert to Key-worker System (PEAKS) Guidelines PAT/EC 4 v.2 Contents Section Page Policy Statement 4 Policy Intention 4 1 Introduction 4 2 Aim 5 3 PEAKS 5 4 Process 5 5 Audit 6 Appendix 1 PEAKS Key-worker Audit Proforma 7 Page 3 of 7

4 POLICY STATEMENT To establish standards of safe practice across the organisation, ensuring that the appropriate person, in the appropriate place in an efficient and timely manner is able to care for patients identified via the PEAKS system when being admitted as an emergency within the Doncaster & Bassetlaw Locality. POLICY INTENTION This policy is intended to ensure patients are assessed prior to admission not admitted to assess and are cared for by the appropriate team in the most appropriate place. It ensures the Acute Oncology CNS /Key-worker is aware of the patient s attendance to hospital and is able to support the patient, carer and clinical team as required. The aim therefore is to reduce inappropriate emergency admissions, reduce emergency length of stay and improve the patient s experience. Cancer Patients: 1. INTRODUCTION 1.1 Doncaster & Bassetlaw Hospitals NHS Foundation Trust provides cancer services to a population base of 430,000 people. Cancer patients may present as emergency admissions into the Trust via a number of different routes. The hospitals A&E Departments would be the main route in, however other areas such as Medical Assessment Units, Outpatient Clinics and transfers from other Trusts would also be utilised by this patient group. 1.2 The Macmillan Lead Cancer Nurse and Macmillan Nursing Team have identified a requirement for a system that will notify a patient s Key-worker when the patient is unexpectedly in contact with the hospital for medical care; either admitted directly as an inpatient or attending Accident & Emergency. The Patient Electronic Alert to Key-worker System (PEAKS) will send messages in the form of and SMS messaging to the Keyworker identifying the patient and location of attendance. This enables contact to be made with clinical staff assessing the patient, to ensure that they are fully aware of the patient s medical history, current diagnosis and cancer pathway. The Hospital Macmillan Nurses work within nine clinical teams comprising; Lung, Breast, Upper GI, Lower GI, Urology, Haematology, Head & Neck, Gynaecology, Acute Oncology and Palliative care. 1.3 The provision of a locally developed patient electronic alert system is implemented to support service provision for cancer patients. This could Page 4 of 7

5 potentially expand in future to include patients with other long-term conditions, patients with known infections and patients who are in their end of life phase. Through an improved cross site communication capability provided by the system, patients will have the assurance that their Key-worker is made aware of their attendance and that they are being cared for in the most appropriate setting by staff with the knowledge and skills required to deliver high quality care. 2. AIM A diagnosed cancer patient attending hospital as an emergency will be registered on arrival. An electronic trigger will enable the alert transmission to the Acute Oncology CNS /Key-worker, to intervene if necessary during normal working hours. At this stage the patient may either not require admission, or if so, be admitted to the appropriate area. The Key-worker will continue to support the patient, carer and medical team throughout the patient s admission with the aim of reducing their length of stay. 3. PEAKS The activation of the alert will happen when the patient arrives at hospital and is registered onto the Patient Administration System (PAS) or Emergency Department Information System (EDIS). This alert informs the Acute Oncology CNS and Keyworker of the patient s whereabouts in the hospital. The Key-worker will contact the department where the patient has presented, to ascertain their reason for attendance. If the reason is related to their cancer diagnosis, the Acute Oncology CNS / Keyworker will attend the department and assess the patient, enabling communication to the medical team about the patient s pathway and treatment plan. In addition the Key-worker can advise about management, especially symptom control and the patient s preferred place of care. The patient s care is further informed by clear communication and of improved quality. 4. PROCESS When a patient is diagnosed with cancer at the site specific Multi-disciplinary Team Meeting (MDT), the MDT Co-ordinator / Key-worker will add the patient to the PEAKS database. When the patient attends any hospital site within the locality in an unplanned capacity, registration of their details onto EDIS or PAS will trigger the electronic alert. The Acute Oncology CNS / Key-worker contacts the area of attendance as soon as possible, within a maximum of four hours, and gathers patient information to assess if an admission is required. Page 5 of 7

6 If admission is necessary, the Key-worker will attend the admitting area and assess the patient in the usual way. The Acute Oncology CNS / Key-worker will liaise with the admitting team informing them of the patient s pathway including the preferred place of care, advance decision to refuse treatment (if in place) and any other relevant information. If the patient can be cared for in primary care or is transferred to another department, the Acute Oncology CNS / Key- worker will liaise with community nursing colleagues especially if a follow-up visit or appointment is required. If the patient is admitted, the Key-worker ensures where possible this is to the appropriate area and is under the care of the Team known to the patient. During the patient s admission the Key-worker continues to work with the team and support the patient and family. For out of hours admissions, the assessing team continue to follow processes developed and agreed by each cancer team, allowing the Key-worker and cancer team to assess the patient at the first opportunity during normal working hours. 5. AUDIT 5.1 The audit form completed by the Acute Oncology CNS /Key-worker will be used to capture key information including; the number of alerts, the nature of the attendance and the response times from the specialist team. See Appendix Information Department support will gather statistics regarding the number of emergency admissions, number of emergency bed days and patient length of stay, on a monthly basis. 5.3 Patient/carer satisfaction will be examined by assessing their experience, via questionnaire and verbal feedback on an annual basis. 5.4 The Lead Cancer Nurse will be responsible for ensuring the audits take place, key performance indicators are met and information is available to support implementation and sustained roll-out. Page 6 of 7

7 Appendix 1 PEAKS Key-worker Audit Proforma PAT/EC 4 v.2 Hospital: DRI BH Department:.. AOS Nurse notified by: AOS Alert Telephone referral from Emergency Area / Ward Appendix A Nurse Assessment Proforma Patient Details Patient History Name DOB / / Hospital No..... Address..... GP..... Reason for attendance: (in patient s own words) Diagnosis: Breast Lung Colorectal Gynae Haemato H&N Skin Urology UGI Unknown Primary Suspected Cancer Consultant.... Oncologist.... Related to: Following treatment Disease Progression/Complications Other.. Route in: Self GP in hours GP out of hours District Nurse WPH Other. Treatment Intent: Curative Palliative Other.. Is the patient on active treatment? Chemotherapy Radiotherapy Other Supportive No State Regime: Are they part of a clinical trial? Yes No When did the patient last receive treatment: 1-7 days 8-14 days days over 4 weeks WHAT IS THE PATIENT S TEMPERATURE: O C (Please note that hypothermia is a significant indicator of sepsis) DOES THE PATIENT HAVE A CENTRAL LINE? Yes No Minor Symptom 0-1 Moderate Symptom -2 Major Symptom 3-4Urgent Action Remember: two ambers equal red! See Guidelines Please Tick box as appropriate below Fever (and receiving chemo) Chest Pain Performance Status Nausea Vomiting Oral / stomatitis Diarrhoea Constipation Fever (not receiving chemo) Infection Palmar plantar syndrome Fatigue Anorexia Dyspnoea / shortness of breath Rash Neurosensory / motor Bleeding Pain Bruising Extravasation Patient s Key Worker contacted? Yes No Date / / Patient s Consultant s team contacted? Yes No Date / / Please document significant medical history/medication Action Taken Discussed with: Oncologist Yes No N/A and/or AOT Member Yes No AOT Member Name: Designation.... Oncologist contacted for: Advice Info only Outcome of Discussion(s) Patient Outcome Admitted to.. Transferred to... Discharged to.. Referred to.... Fast track appointment arranged Yes No Fast track clinic tumour group Died in (please state). Other (please state)... Have you prevented any unnecessary tests? Yes No If so please state;... Has your intervention prevented an admission? Yes No Signature:... Print:.. Designation:... Date: / / Time: : Top copy: Patient s Casenotes Duplicate copy: Clinical Audit Department Triplicate copy: Patient s Key Worker Page 7 of 7