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CCOT Quality and Operational Standards. NORF 2020. - Coggle Diagram
CCOT Quality and Operational Standards.
NORF 2020.
Patient Track and Trigger.
Patient Track for Recording review & NEWS.
Achieved (1.1-1.6)
A patient/family -activated escalation
Requires development (1.7)
Rapid Response
Graded clinical response (Nice Guidelines CG50)
Review Required!! (2.1)
Level of response what is required Therefore SOP for Risk Rating Action Required. (2.2)
Clear Escalation Policy. (2.3) HDFT. policy Available.
Team members must have appropriate Competencies for the deteriorating patient.
Review NORF Competencies S1 + Norf CCOT & HDFT CCOT (2.4)
Outreach teams require necessary Equipment to be able to respond .
No Equip at present pls Review (2.5)
No system for patient or family activation at present
Review required.
Education, training and support.
3.1 Each organisation must ensure patients receive care from appropriately trained, including.
An induction programme
Access to and provision of a training programme
Annual competency-based assessment
3.2 All CCO practitioners must have demonstrable evidence of post-registration study in relevant clinical modules in critical care and/or acute care.
3.3 All CCO practitioners must be Advance Life Support providers
3.4 CCO practitioners must be able to asses and provide first line treatment for the acutely ill .
MEDICAL AND SURGICAL EMERGENCIES.
ANNUAL REVIEW OF SKILLS AND COMPETENCIES.
3.5 Practitioners undertaking intra- and inter- hospital transfers must have received formal training.
3.6 CCO practitioners must be trained in palliative care both recognition and referal
Also 3.6 recommendation for CCOT to be prescribers
3.7 CCO practitioners must be able to provide effective leadership and support for ICU & Wards.
3.8 CCO practitioners must understand their clinical limitations and enable direct referral all MDT Memembers.
3.9 CCO practitioners must be able to demonstrate continuous professional development + appraisal.
3.10 Where there is an expected corporate function to deliver education and training to the organisation, CCO Teams must be given the necessary resources and support.
Patient Safety and Clinical Governance
4.1Each organisation should deliver the seven core elements of Comprehensive Critical
Care Outreach PREPARE.
4.2 clearly defined referral strategy, to support acutely unwell for CCOT 24/7.
4.3 Each organisation must have a clear Operational Policy for Critical Care Outreach or equivalent teams that delineates the team’s remit and includes the seven core elements of Comprehensive Critical Care Outreach - PREPARE.
4.4 Regular link with patient safety teams. 2 way communication.
4.5 system for reporting learning investigating (DATIX IN PLACE)
4.6 participation in mortality and morbidity meetings.
Audit and evaluation, monitoring of patient outcome & continuing Quality of Care.
5.1 must participate in NORF minimum data set.
suggested data to collect is..
(1) Number of individual patients following critical care Discharge.
(2) Number of clinical reviews (individual visits) after CC discharge.
(3) Early Re-admission to CC <48hrs post dis.
(4) Patients followed up after triggers or Referrals
(5) Number of Calls to CCOT
(6) Numbers of patients referred to CCOT
(7) Number of patients attended by CCOT
(8) Number of clinical Reviews for non CC referred patients
(9) Number of Calls to cardiac arrest team per 1000 admissions.
(10) Number of potentially preventable cardiac arrests.
(11) Number of DNACPR & Treatment Escalation Plans involved with
(12) Timely review of deteriorating patients by ward team
(13) Timely referral of deteriorating patients to CCOT
(14) timely intervention to deteriorating patient by CCOT
(15) Timely admissions to CC when appropriate.
(16) Number of patient or carer Referrals.
(17) Length of stay both in CC & Hospital. pt meeting detrioration criteria.
(18) Source of Referral.
5.2 regular service improvement evaluation and GAP analysis
5.3 Process of Peer Review.
5.4 participate in patient and staff satisfaction survey
Rehabilitation after Critical Illness.
6.1 Rehab Pathway operational Policy ( NICE CG83 & QS158) with clear lines of accountability.
6.2 follow up of all cc patients whose stay .24hrs (within 24 hrs of discharge)
Rehab plan to continue after step down on the ward with clear lines of communication .
6.4 CCOT to adhere to principles of critical care Rehabilitation & support recovery trajectories.
6.5 CCOT should provide stepdown support including alternate pathways i.e palliation
6.6 CCOT should be part of MDT of post cc ward patients liaising with CC recovery services.
Enhancing Service Delivery, Through quality Improvement, collaboration and Co-ordination.
7.1 Should be 24/7 365 days per year.
7.2 Must be supported by Consultant with CC specialty
7.3 CCOT demonstate involvement with public groups ensuring views are reflected
7.4 CCOT demonstrate engagement and involvement with relevant stakeholders
7.5 CCOT demonstrate involvement with and report to local commissioners.
7.6 Size of team must be appropriate to work load and other responsibilities.
7.7 CCOT provision to be reviewed regularly to enable a proactive approach Must be reflected in our Operational policy .
7.8 Actively participate in research