Update 05: EMP – From Planning to Implementation

The Emergency Medicine Programme (EMP) will transition from planning to implementation in the New Year. A considerable amount of work has gone into the programme to date and I would like to thank not only the working group, the advisory group and members of the Academic Committee of IAEM who undertook guideline development, but all IAEM members who contributed to the programme’s work during the past year.

Update issues

1. Documents now available to IAEM members:

   a. Draft of First Steps document, a guide to the actions ED and hospital teams need to undertake to start to implement the EMP.
   b. Slide presentations from ED overcrowding Seminar from 14th November 2011
2. Dissemination of First Steps document to acute hospitals will occur shortly. This is in draft consultation format but is based on EMP report and in our view is unlikely to change significantly.
3. The EMP Report is due to go for limited consultation within health service in the next fortnight. The report will be finalised after review of feedback – we estimate that this will occur at the end of January 2012.
4. Site visits: Representatives of the EMP working group, including regional reps, will visit acute hospitals and meet hospital management and ED teams to discuss implementation of the EMP. We will email Consultants in EM prior to visits.

   a. Sites completed: Cork University Hospital; Mercy University Hospital; Waterford Regional Hospital and Wexford General Hospital
   b. Sites planned December 2011- Our Lady of Lourdes Hospital, Drogheda; St Luke’s General Hospital, Kilkenny; South Tipperary General Hospital, Clonmel; Galway University Hospital; Portiuncula Hospital, Ballinasloe; Kerry General Hospital, Tralee; University Hospital (formerly Midwestern Regional Hospital), Limerick and St John’s Hospital, Limerick.
   c. All other sites in early 2012.
5. EDIS procurement:

   a. The procurement document goes to CMOD for review in the coming weeks. Their decision is unlikely to be available for some time afterwards.
   b. The EDIS project working group met for the first time on 1st December. Ronan O’Sullivan chairs this.
   c. There will be consultation with IAEM members on key deliverables associated with the EDIS project including ED administration mini-dataset and diagnostic coding.
   d. CMOD requires EDIS-implementing EDs to undertake process improvement initiatives to optimise EDIS implementation. The EMP and EDIS working groups will support EDs in this regard.
   e. A survey of ED computer hardware has been completed.
6. Clinical guidelines: These will be hosted on the EMP website when this becomes operational. Discussions to deliver this website are ongoing. The first guidelines planned include:

   • Anaphylaxis in children
   • Asthma in children
   • Bronchiolitis
   • Croup
   • The Fitting Child
   • Suspected SAH, in collaboration with the Neurosurgery Programme
   • Status Epilepticus, in collaboration with the Epilepsy Programme
   • Head injury, in collaboration with the Neurosurgery Programme
   • Emergency Management of Patients with Implantable Defibrillators
7. Emergency Nursing Interest Group: This group includes CNMsufrom every ED in the country. Key work-streams include:

   a. Evaluation of a national paediatric triage tool – the Irish Children’s Triage System
   b. Evaluation of a Mental Health Triage Tool, developed in collaboration with the Liaison Psychiatry Faculty of the College of Psychiatry
   c. Nursing Guideline Subgroup – review of EMP and other programme guidelines
   d. Development of standard job descriptions for Emergency Nurses and ANPs
   e. Development of a workforce plan for Emergency Nursing
   f. ED ANP Subgroup – development of job descriptions, standardisation of required competencies and training, workforce planning for ANPs.
8. ED Staffing and Infrastructure:

   a. The 2012 Staffing and Infrastructure Survey will be circulated through the CMNs shortly – please support them in completing the survey and encourage prompt return of completed surveys.
   b. The EMP has been tasked by DCSP to produce a long-term workforce plan for medical staffing in EM. This will be progressed in early 2012.

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