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Recurrent AdmissionPatientAlert

The RAPANHS Improvement Initiative addresses critical issues in cancer inpatient admissions. Patients were often sent to inappropriate wards and attended to by unsuitable clinicians, complicating their care. The Service Improvement Team implemented the RAPAN system to ensure timely notifications about patient admissions, assigning Clinical Nurse Specialists as Key Workers. This initiative, tested between 2006-2010, significantly improved patient experience and streamlined care, reducing average inpatient stays for lung and lower GI patients and ensuring individuals are greeted on arrival by familiar faces.

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Recurrent AdmissionPatientAlert

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  1. Recurrent AdmissionPatientAlert

  2. NHS Improvement- Cancer Inpatients Case Studies Background of RAPA • • Patients going to inappropriate wards • • Patients being cared for by inappropriate clinicians • • Having to explain their medical history at A&E

  3. RAPA • Positive diagnosis of cancer in the tumour site groups of Breast, Gynaecology, Lower GI and Lung. • The Service Improvement (SI) Team added these patients to the RAPA system, in order to notify each team member of patient’s admittance to hospital. • A “Key Worker” was assigned to each patient, this being a Clinical Nurse Specialist (CNS). • Blackberry devices provide instant access to an alert for the Nurses

  4. RAPA • Results of Testing (16/08/2006 –18/02/2007) • received well and has benefited many patients. • We have reduced non- elective Lung patient length of stay from 8 days to 6. and Lower GI from 9.5 to 5 days • Patients are being met on arrival by a friendly face and are being directed to the right wards • Two patients have been met and given symptom control and seen at the rapid access clinic therefore avoiding unnecessary admittance

  5. RAPA • First Trust in London • 2006 National Service Improvement Programme ‘Going Further with Cancer Waits’ • 2007 Cancer Service Collaborative Partnership&Publication called ‘Bridging the Gap’ demonstrated a significant release of bed days

  6. RAPA • 04/02/2010-07/06/2010 • 48 alerts- equal over days of week • 27 out of hours • 15 absent • 13 alerts while I was present- I saw 8 of them in a/e

  7. RAPA • VS – 69 f Expressive dysphasia; diagnosed with cva; had DXT to spinal met whilst inpt, then home (22/02-26/02) • DJ- 61 m Fever/sob-ivabs/blood tx (Hb 9.1) (23/02- 25/02) • CS- 64 f Central chest pain/pericardial effusion- cardiology opinion-no intervention; spiked temp/blood tx (22/04-26/04) • VAS – 57f –off her legs (15/04-rip 20/05) • AB- 62 m- epigastic pain/vomiting-USS NAD/pain improved (22/04-23/04) • CC- 61 f- GP blood tests showed pancytopenia- abs (27/04-04/05) • VM – 68 f- generally unwell/weak/not eating (30/04- rip 19/05) • ZW- 81 f – bad leg- not cancer; not admitted

  8. RAPA

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