{
  "abstract": "Background Many UK trusts operate across multiple sites. This presents unique challenges, for both Emergency Departments and the Ambulance Service, who are mandated to provide inter-hospital transport.Wrong site patient location contributes to the pernicious phenomenon of ED crowding, recognised by RCEM as ‘…a major threat to public health’.This project was conducted within Leeds Teaching Hospitals, a split-site trust. Previous work identified the major contribution to crowding that elderly patients made at one site whilst awaiting transfer, with cubicle hours incurred in one month standing at 2204.Clearly, getting patients to the right place first time improves their care and experience, and aids departmental flow by reducing exit block and strain on the Ambulance Service.Our project aimed to change local pathways for conveyance of patients to reduce the number of frail people taken to the incorrect site at initial presentation.Methods This was a Quality Improvement Project conducted over six months. Changes were made to the local JRCALC guidelines about which elderly patients to transfer to either site. Ambulance crews were educated about the change using a variety of methods, including deploying a Hospital Ambulance Liaison Officer (HALO) paramedic to directly support them. Data was gathered pre and post intervention about the number of transfers and length of stay in department.Results A significant reduction in the number of patient transfers was seen, with a sustained average reduction of 24 patients per month over the 6 month follow up. This equates to a projected ‘time in wrong department’ saving of 408 hours.Conclusions Our work illustrates that significant improvements in patient care and reduction in emergency service workload can be made by initiating a targeted, low-cost intervention supported by multi-level stakeholder engagement, including a HALO paramedic. This project paves the way for further development of appropriate site conveyance guidance.",
  "authors": [
    {
      "affiliations": [
        "Leeds Teaching Hospitals, UK"
      ],
      "name": "Eleanor Syddall"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals, UK"
      ],
      "name": "Samantha Maxwell"
    },
    {
      "affiliations": [
        "Yorkshire Ambulance Service NHS Trust, UK"
      ],
      "name": "Toby Bellis"
    },
    {
      "affiliations": [
        "Leeds Teaching Hospitals, UK"
      ],
      "name": "Stuart Nuttall"
    }
  ],
  "title": "02 Reducing inter-hospital transfers for the frail elderly; a joint emergency department – ambulance service project",
  "uid": "257135d9-9eb7-5437-8b18-4dfaee8564b8"
}