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Roles – who are they and what do they do?
Stuart Nuttall Thursday 7 October 2021

Who is in charge of the shift in your ED?  Who makes decisions regarding site operations out of hours? Who is “on call for ICU”?

EPIC, NiC, CIC, CSM, ADOP, Reg on call, Doc in the box, Matron for escalation, Bronze command etc etc

Every hospital has them and they are key to how hospitals and departments run.  Often they are a different person on a different day too – even different people at different times of the same day.  How do you keep track of who is working in each Role at a specific time of day?  What are the expectations for individuals when working in those Roles?  How do you minimise variation in interpretation of a departmental status and variation in responses between those situations while allowing people autonomy from day to day and individual to individual?  How can you ping a notification to a Role to notify them of an operational event e.g. surge in attendance, block to flow, lack of pods to send samples to the lab for instance in real time!  

We have seen a variety of options – whiteboards, excel sheets printed out and stuck on boards in offices, rota’s emailed out weekly etc. We see operational escalation plans that always reference Roles rather than individuals and so it became clear when designing a hospital “operating system” like CEMBooks V2 that we needed to focus on these Roles and their associated activity. This includes “Sign In” processes, accessibility and visibility 24/7 alongside direct contact information.  

During implementation we work with teams to ensure that their escalation plans are directed to the correct Role at the correct time of day.  Roles can be tagged in Sit reps and Logs and these will all result in push notifications going to the device or desktop of the individual signed into that Role. It even pops up directly on your watch face if you have a smart watch!! 

Within the Phone book you can clearly see who is currently signed into a Role and how to contact them (see below – real numbers redacted).  

In a future blog we’ll talk about behaviours around signing into Roles and some of the experience we’ve had around that, but we’d love to hear from you in the comments below about what are the key roles in your organisation and how do you know who is doing that Role today and how and when you should contact them.

Till next time!

SN 7/10/21