Article | Managing Departments

This article is part of a series written by Optum Clinical Director and Consultant Emergency Physician, Dr Haidar Samiei. Read the previous article in the series here.

Emergency Departments (EDs) are expanding into urgent and emergency care (UEC) footprints, with fragmented same day emergency care (SDEC) areas complete with physical and virtual clinics. As a result it's increasingly important to be able to see not only the whole, but also dive down to the specifics, of exactly what is happening where.

They need to see pertinent demand, capacity and performance information is increasing. Departments are implementing escalation plans and increasing their staff numbers with teams requiring bespoke views to manage both their individual workload and react to the overall UEC footprint demands in a flexible predictive fashion.

These new teams need to see the whole UEC footprint story, their part of the story, and be able to dive into patient specifics. The Symphony roadmap has improvements planned that will allow greater visibility within web viewer to support this.

Symphony will soon have improved dashboards that allow you to identify cohorts of patients and drill down to patient-level detail. This will bring together their pre-ED history (GP record view, 111 triage information, ambulance transfer documentation) alongside their ED history and any documents associated with the patient to help make meaningful decisions.

Symphony will use the Web Viewer capability for this, which means that anyone with appropriate access can do this remotely where best suits them. This eases the workflow of clinicians and managers alike to better identify and manage cohorts of patients. It also allows us to start our move away from the desktop client into a new web-based world.

We have also recently partnered with CEMBooks, a solution that turns key performance indicators (KPIs) from Symphony into Operational Pressures Escalation Levels (OPEL). It allows you to tie data from Symphony 3.0 and above, to both a narrative of what’s happening across the UEC footprint, escalations, standard operating procedures and allows communication between team members. By OPELising the data as KPIs you can assess demand, surface required escalations, adherence to them and internal professional standards. Acute care is no longer the sole arena of the ED Consultant, as we see the development of acute medicine and emergency general surgeons to share the risk and demand across SDEC areas.

CEMBooks empowers organisations to clearly document how and when they maintain safety at times of stress in the system and by making improvements metrics part of the BAU KPIs.

It’s really encouraging to feel the impact of SDEC in the working environment, for staff as well as patients. There is a palpable feeling that we are just setting out on this journey, and many are starting to see the opportunities that SDEC provides. We are focused on enabling as many improvements as we can, and our roadmap is packed with exciting developments like the ability to add notes using the web viewer. We’re also working hard to see how we can best use emergency care data sets (ECDS) V4 meaningfully across the urgent care footprint. I’m really looking forward to using the upcoming new features as we introduce them this Autumn and I hope you’ll all benefit from this new functionality.