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Theme: Evidence for Policy and Practice
The Royal Devon & Exeter Hospital (RD&E) would like to introduce a Clinical Decision Unit (CDU) to support processes at their A&E department. Initially, it was planned that the CDU should have space for four patients at any one time; however, it is not known whether this is the most efficient size, as the number of patients who would be suitable to be referred to the CDU varies considerably at different times.
This modelling project will assess what size of CDU is most suitable, and what the effect of having a CDU would be on patients’ overall length of stay in the A&E department. It will also assess the optimum opening times for the CDU.
The project developed from an HSMA project by Alaric Moore, Performance Improvement Manager at the RD&E, which worked with clinicians and patients to map out the processes involved in A&E treatment at the hospital. This research highlighted the complexity and interdependencies of the current processes, providing vital groundwork for PenCHORD’s project.
The project has two key objectives:
A prototype simulation model has been built, using historic anonymised data records in order to replicate the current activity in the hospital's A&E department. Together with the department’s Cluster Manager and Lead Consultant, admission policies have been developed which are currently being evaluated in extensive simulation experiments.
The project team’s report to the Royal Devon & Exeter NHS Foundation Trust will feed into scoping for the CDU. This study aims to help inform a £multi-million decision around strategic planning in A&E at the Trust.
When the CDU is implemented, PenCHORD aim to track how much it is used and the rate of admissions, and compare this to the modelling outcomes, with a view to publishing a paper on the project.
Royal Devon & Exeter NHS Foundation Trust
Alaric Moore - Performance Improvement Manager, Operations Support Unit
Laura Custerson - Cluster Manager Acute and Emergency Medicine