Ensuring patient safety during the development of ambulatory emergency care

Abstract

The Hillingdon Hospitals NHS Foundation Trust runs an ambulatory emergency care (AEC) service from the Emergency Assessment Unit. The AEC clinic is staffed by one nurse and one senior doctor. However, what was initially a ‘swollen leg’ clinic has now become the basis from which AEC is provided. This change in the service has developed over a six-month period from June to December, and will continue to expand beyond 2014. AEC improves upon existing patient pathways and clinical care through the use of investigations and treatments that are accessible from home. However, at the core of this pathway lies the inherent risk of patients being lost to follow-up and, consequently, deteriorating in the community. The creation of a thorough referral form designed by clinical and administrative staff allowed the capture of granular data, which was used to build a database of patients who were being ambulated to improve patient safety. Improved clinical governance through the creation of a ‘virtual ward’ using the information captured by the referral forms and database has enabled growth of the AEC service to allow more complex cases to be safely managed by this pathway.