10 June 2019

 The Trust that runs Shropshire’s two acute hospitals is working to improve its urgent and emergency care with two Acute Medicine Start of Change Weeks.

Emergency and Acute Medical Care teams at The Shrewsbury and Telford Hospital NHS Trust, which runs the Royal Shrewsbury Hospital (RSH) and the Princess Royal Hospital (PRH) in Telford, have been working with colleagues to identify ways to improve how and where patients are treated as they enter both hospitals and how efficiently and effectively their treatment progresses.

The redesign work aims for patients to be seen by the right senior clinician for their needs more quickly and to be cared for in a better environment. Pressure will be relieved for our busy A&E departments, allowing them to stream patients more efficiently and Acute Medical Unit (AMU) ward staff will benefit from receiving appropriate patients with less delay.

Acute Medicine Start of Change Weeks will take place at RSH from 10-16 June and at PRH from 17-23 June. During these weeks, AMU, Short-stay (SS) and Same Day Emergency Care (SDEC) teams will test out the changes they have been developing, continuing those that work well throughout the month and beyond.

Acute Medicine Start of Change Weeks innovations include:

 A Revised Acute Medical Model

  • The Clinical Decisions Unit will become an Acute Medical Assessment (AMA) area with a mix of beds and AMA trolleys to assess patients ‘at the front door’, meaning they will be seen by a senior clinician more quickly.
  • An AMU Ward will work for patients requiring direct admission.
  • Acute Medical Clinic / SDEC will look after patients who come through AMA and can be treated and sent home on the same day.

Protected and enhanced services

  • Protected ward areas for emergency patients will ensure patients requiring a bed get to the correct ward where they can be treated by the right staff more efficiently, enabling a faster discharge.
  • The skill-mix of staff, extended hours of service and increased weekend cover across acute medicine will be tested, informing the correct staffing models required moving forward.

Improved systems and processes

  • The daily rhythm and clinical pathways at AMU and SS will be adjusted to make them as efficient as possible. This will include work on: board rounds, ward rounds, early pull (specialist coming down to identify appropriate patients) and discharge.

Nigel Lee, Chief Operating Officer at SaTH, said: “We are looking forward to putting into practice all the developments we’ve been working on for our Acute Medicine Test of Change Weeks, and we invite the support of all specialties, disciplines and support services across our hospitals.

“Effective Acute Medical and Same Day Emergency Care services means improved quality, safety and effectiveness within our hospitals, so I want to ask all staff to fully support our emergency care teams in testing new ways of working to improve care for our patients.”

Staff can get involved by:

  • Visiting the AMU and short-stay wards to offer support
  • Join daily huddles which are open to all staff at 3pm:
  • 10-14 June at TCI Innovation Suite, RSH
  • 17-21 June at Meeting Room 1, Admin Corridor, PRH
  • Contact the AMU/SS/SDEC Improvement Group via Sarah Mattey, PA to Emergency Centre Management Team: sarah.mattey@nhs.net