‘Medical Emergency’ and ‘Cardiac Arrest’ teams are deployed in a number of hospitals in the UK. Usually comprising of a medical registrar, medical house officers, an intensivist or anaesthetist and critical care nurses; this team manages the treatment of patients who become acutely unwell on a hospital ward.
The Royal Sussex County Hospital (RSCH, Brighton, UK) has over 500 beds and serves as a tertiary referral centre in South-east England. There is no strict definition or criteria for a medical emergency at RSCH, with the emphasis upon staff that a call should be put out for any patient they are acutely concerned about. This typically correlates with a high NEWS (National Early Warning Score) score.
During the initial assessment and investigation of these patients, basic laboratory tests are invariably performed. The results of these tests are often vital in establishing a diagnosis and guiding a management plan. As such, a positive outcome for the patient may rely upon prompt reporting of these tests. Anecdotal reports from medical staff at RSCH suggested that laboratory test results for these critically ill patients were often slow to be reported.
As such two members of the medical team (Foundation Year 2 doctors) determined to identify the factors contributing to delays and design interventions to resolve them. Given the importance of haste, our initial SMART aim was to speed up the reporting of laboratory tests by for patients who are in a ‘medical emergency’ or ‘cardiac arrest’ by 50% over a 2 month period, and for this improvement to be sustained.
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