RT Journal Article
SR Electronic
T1 Towards a standardised method of patient prioritisation that accounts for clinical harm
JF Future Healthcare Journal
JO Future Healthc J
FD Royal College of Physicians
SP fhj.2020-0109
DO 10.7861/fhj.2020-0109
A1 Rowan Wathes
A1 Karina Malhotra
A1 Kelsey Flott
A1 Arup Nath
A1 Catherine Urch
YR 2021
UL http://www.rcpjournals.org/content/early/2021/02/11/fhj.2020-0109.abstract
AB COVID-19 has highlighted the need for a standardised approach for prioritising patients requiring elective care. The Royal College of Surgeons of England (RCS) developed guidance at the start of the pandemic for prioritising surgical patients based on the urgency of different procedures. Imperial College Healthcare NHS Trust (ICHT) has extended this to all aspects of elective care to enable standardised decision-making based on clinical priority, clinical harm and patient vulnerability. This was a clinically led project that involved close collaboration with lay partners, who were concerned that the RCS guidance lacked the sensitivity to reflect individual patients' needs. Our novel elective care recovery matrix is designed to be applicable across all elective care services and at Trust or system level. Implementation at ICHT progressed rapidly: as of 28 August 2020 >200 consultants have received training on the process and 58% of all surgical orders have been prioritised using the new framework (5,134/8,800). While COVID-19 was the driver, the applicability can be wider and could inform new ways of working. The framework enables rapid quantification of individual patient care requirements, thus enabling clinicians to target more accurately those patients with the greatest need and those who would see the greatest benefit.