The Getting It Right First Time (GIRFT) Urgent and Emergency Care Programme continues in 2024 with the UEC Further Faster Programme being rolled out through this spring. The previous focus of GIRFT has been on outpatient care so it’s great to see the principles being applied to Urgent care. The focus of the programme in Emergency Medicine is to provide Trusts with accurate information to identify the best ways to meet the demand for emergency care from their catchment population, emphasising the use of the Summary ED Indicator Table – SEDIT table.
This GIRFT-developed clinical data tool enables EDs and their trusts to understand the relationship between demand, capacity, flow and outcomes to support patient outcomes and safe discharge. It is a monthly dashboard that is updated and accessed centrally, offering the most up-to-date data for each of the 170 Type 1 EDs in England. Devised by GIRFT clinical experts for emergency medicine, Dr. Chris Moulton and the late Dr. Cliff Mann, the Summary Emergency Department Indicator Table (SEDIT) features over 50 metrics displayed for easy comparison.
These SEDIT tables can be used to identify key performance or acuity indicators that may be reported hourly and certainly daily within a system such as CEMBooks, allowing daily updates rather than waiting for monthly data from the SEDIT dashboard.
The next iteration from the SEDIT dashboard is the GEMI score, a total score after adding together the scores for three key metrics: four-hour ECS performance, admissions over 12 hours, and ambulance handovers over 30 minutes. The GEMI score is the GIRFT Emergency Medicine Index of Patient Flow score and allows trusts to be ranked based on their overall score in these three key performance metrics. Similarly, the GAMI score, the GIRFT Acute Medicine Index of Patient Flow score, is based on the GIRFT SAMIT tables(similar to the SEDIT tables for the ED but for acute medicine), showing the close ties between acute medicine and ED regarding acute patient flow.
This is the future of understanding key productivity areas and where improvements can be made across organisations in relation to emergency care. Many areas have already started to develop successful SDEC and urgent care treatment options that allow most ambulatory patients to be streamed away from the ED. The next focus will need to be on majors and resus cubicles and patient flow into the organisation and how this can be improved.
The CEMBooks team have long argued that key performance indicators such as these give you a key to the demand and acuity of your department. While the SEDIT dashboards provide this data monthly, using a tool such as CEMBooks to monitor and operationalise this data daily and help match capacity to demand through workforce planning software such as Patchwork or Doc Abode, aligned with cubicle occupancy and productivity metrics, is where the real gains will be made in the coming years – helping to improve patient flow and care for patients being admitted through our emergency departments.
Ref https://gettingitrightfirsttime.co.uk/medical_specialties/emergency-medicine/