as an emergency 5 Date and time of admission at hospital as an emergency Date Entry & Time Entry 6 Date of discharge (includes date of death, discharge date and transfer out of hospital) Date Entry 7 Date and time of the 1st consultant review? Date Entry & Time Entry 8 If 1st review was not within 14 hours of arrival at hospital, what is the reason? Survey tool will flag when > 14 hours elapsed between arrival and 1st consultant review. Optional Free Text 9 What was the date and time discussions about initial review, which may include the diagnosis, management plan and prognosis, were had with the patient (and where appropriate families/ carers). Date Entry & Time Entry 10 If the patient (and where appropriate families / carers) were not involved in discussions about the initial review within 48 hours of admission, what was the reason? The patient was unable to be made aware due to their clinical condition The patient died within 48 hours Family/ carers could not be contacted or there are no family/ carers to be informed None of the above Clinical Standard 8 – Ongoing Review The questions in this section use question routing based on your response as to whether the patient required twice daily review or once daily review. These questions are to be answered for each day that the patient is subject to reviews (up to a maximum of 5 days). The questions that display for each choice are shown in the table below: Questions for Once Daily review: Q No Question Response options 1 Day Two: Date Date entry (automatically filled) 2 Day Two: Specialty List as appendix A 3 Day Two: Did the patient require twice daily review? Patient required twice daily review Patient required once daily review Patient required no review 4 Day two: Did the patient receive a consultant review on this day (between Yes -patient received a consultant review (record date and time) Yes - Consultant review was delegated and done by delegate (record date and time) No –patient review was delegated but not done No -patient was not reviewed No, but patient was discharged 5 Day two: what was the date and time of the completed Date and time to be entered
2nd completed twice daily review 8 Day two: Who undertook the 2nd review? The consultant Senior trainee 3+ (ST3+) Advanced Nurse Practioner / nurse specialist Other Nurse Other doctor Other Health Care Professional During the period the patient was reviewed were they informed of review outcomes or any changes to care plan? Asked once over consultant review period Yes The patient was unable to be made aware due to their clinical condition. The carers/ family were informed Neither the patient nor their family was informed None of the above Standard 8 - Managing the Deteriorating Patient: To be asked once 9 What was the date and time of the first NEWS score which triggered the need for a response according to your local protocol, during the first 6 days of the inpatient stay Date Entry and Time Entry No response was triggered during the first 6 days of the inpatient stay’ (tick box) 10 What was the level of the trigger Red / High Score Amber / Moderate Score 11 What was the date and time of the response? Date Entry and Time Entry 12 What were the grade and/or profession of the initial responder? Consultant Senior trainee 3+ (ST3+) Other doctor Critical care outreach team nurse Critical care outreach team doctor Other nurse 13 Was the response followed by a consultant response on the same day? Yes No N/A (Plus optional free text) 14 Is the clinical opinion that the patient deterioration triggering a high / moderate NEWS was due to sepsis? Yes No 15 Did the patient require an unplanned admission to PICU or ICU during the first six days of the inpatient stay? Yes No 16 Was there an unplanned Yes
Repeat for: CT Echocardiograph Histopathology MRI Microbiology Upper GI Endoscopy Ultrasound Also repeat each of the above for: Weekday Saturday Sunday The survey tool will calculate a mode of the responses to this question to provide an overall trust response. Trusts will be able to see their own detailed local data. 3 How often are you able to access the following diagnostic tests and reporting for emergency admissions as quickly as you require, when you believe there is an urgent clinical need? Repeat for: CT Echocardiograph Histopathology MRI Microbiology Upper GI Endoscopy Ultrasound Also repeat each of the above for: Weekday Saturday Sunday This test is always available for patients This test is usually/ mostly available This test is sometimes available This test is not usually available This test is never available The survey tool will calculate a mode of the responses to this question to provide an overall trust response. Trusts will be able to see their own detailed local data. 4 What changes to your access to diagnostics do you intend to implement as a result of the Local Diagnostics/Interventions Survey?” Free Text Clinical Standard 6 : Consultant Directed Interventions Data for clinical standard 6 will also be collected from two sources: 1. A question will be included in the local survey (outlined in Clinical Standard 5 above) asking consultants who take emergency admissions, to report on the availability of interventions for their patients across the week. A preview of the questions within this local survey can be viewed at the following link: (please note this is the preview link, not the link to the live survey).
To access the link to the real survey please log onto the tool and access the Consultant Directed Diagnostics or Consultant Directed Interventions tab. 2. A self-assessment question on the availability of interventions either on-site or via a formal network approach. The collated data from the local survey detailed above for your trust will then be automatically used to populate the fields below, which can be checked before approval / sign off. This data will be populated in the tool by Friday 30th September. Q No Data item Responses 1a Total number of Consultants who take emergency admissions at your trust Number 1b Total number of Consultants who responded to the Local Diagnostics/Interventions Survey Number (This will be completed for you after the survey deadline has passed – by the 30th September) 1c % of Consultants (who take emergency admissions) who responded to the Local Diagnostics/Interventions Survey Auto-calculated 2 How often are you able to access the following interventions for emergency admissions as quickly as the clinical need of the patient requires? Critical Care Primary Percutaneous Coronary Intervention (PPCI) Cardiac Pacing Thrombolysis for Stroke Emergency General Surgery Interventional Endoscopy Interventional Radiology Renal Replacement Therapy Urgent Radiotherapy Repeat the above for: Weekday Saturday Sunday This intervention is always available for patients This intervention is usually/ mostly available This intervention is sometimes available This intervention is not usually available This intervention is never available The survey tool will calculate an average (mode) of the responses to this question to provide an overall trust response. Trusts will be able to see their own detailed local data. 3 What changes to your access to interventions do you intend to implement as a result of the Local Diagnostics/Interventions Survey?” Free Text 4. Do inpatients have 24 hour access to consultant directed interventions 7 days a week, either on site or via formal network arrangements? Three Responses: Weekday / Saturday / Sunday Critical Care Yes – on Site Yes – off Site (via formal arrangement) Yes – off Site (NOT via formal arrangement) Mix of on and off site (all by formal arrangement) No Primary Percutaneous Coronary Intervention Yes – on Site Yes – off Site (via formal arrangement) Yes – off Site (NOT via formal arrangement)