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Scottish Patient Safety Paediatric Programme

Scottish Patient Safety Paediatric Programme. Adverse events and the Paediatric Trigger Tool (PTT). PTT – Ramp for Testing. PTT - Sampling. Data of discharges within a calendar month is supplied by the Performance Review Department Monthly discharges range: 300 -500 Data filtered to

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Scottish Patient Safety Paediatric Programme

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  1. Scottish Patient Safety Paediatric Programme Adverse events and the Paediatric Trigger Tool (PTT)

  2. PTT – Ramp for Testing

  3. PTT - Sampling • Data of discharges within a calendar month is supplied by the Performance Review Department • Monthly discharges range: 300 -500 • Data filtered to • exclude all patients ≤ 29days old • ensure length of stay is > 24hours (identified as 2 days) and ≤ 30 days • Data randomised and first 20 cases listed • Notes are then obtained from Health Records

  4. PTT – Case note preparation • Case notes ‘traked out’ by health records staff • Discharge letter / nursing notes / drug chart of relevant admission marked with post-its to speed up review by clinicians (absence of part of the documentation does not exempt the notes from the review) • Case notes collected from records en route to the review and returned at end of review • Case notes ‘traked back’ in by health records staff

  5. PTT - Review • 20 case notes • Team of Reviewers • 10 minutes per case note • Consultant reviews sample note • Clinical Effectiveness Facilitator collates findings

  6. PTT - Reviewers • Paired to cover for clinical duties & annual leave • Continuity provides consistency • Training • Discussions over any queries • Team work • Avoid person dependant processes

  7. PTT – Trigger & Adverse Event Data

  8. PTT – Adverse event story

  9. PTT – adverse eventcase note review summary

  10. PTT – Run chart

  11. Thank you • Peter Lachman & NHS Institute for Innovation & Improvement • Fiona Gardner • RHSC Health Records Staff • Julie Freeman • Ulf Theilen • Laura Reilly • Karen McGrath • Merrill McHoney • Annette Henderson • Ross Davies • Niall Blackie RHSC, NHS Lothian, Children’s Services, June 2010

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