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Service Improvement and Leadershipas a SAS Doctor 2023 Andrew Kerr – Cardiology Specialty DoctorSAS Doctors as Leaders? • There is unconscious bias about the role of SAS doctors, and it is often assumed that we are service provision only doctors. However • A SAS Career can be as rewarding and diverse as you want it to be. • A SAS Career doesn’t stand still.Development of SAS Doctors “Ensuring that SAS doctors receive effective development will benefit patients, employers, and doctors. Good patient experience is strongly associated with a motivated and engaged workforce where every individual has the opportunity to work at their full potential.” Cardiology Clinical Role My SAS Educational Service Supervisor Career Improvement SManageronalMy SETrust Experience • both my clinical skills, leadership and educational skills the trust to developClinical Leadership • Clinical leadership is vital to the success of healthcare organisations. • Failure of leadership is a significant contributor to harm, as highlighted in the Francis enquiry, the Keogh mortality review and Don Berwick’s patient safety papers. • Research findings also support the positive impact of clinical leadership on trust performance, safety, and finances.MSc in Business Improvement • improve their organisation's operational performance.ement strategies to • Combined course with private and public sector employees.My Role in Medical EducationSAS Led Service ImprovementsWhy Change - Rethinking Care in Smaller Hospitals • Smaller hospitals need to be part of a wider system, with strong links to local services and support from other hospitals • There needs to be a shift from the ‘all or nothing’ understanding of acute service provision to one that is more ‘modular’ • Systems and processes in hospitals should be organised, as far as possible, with the intention of delivering the appropriate care to the patient as quickly as possible“The trend has been to make the smaller hospital seem a near irrelevance in the NHS landscape” Nuffield trustUSC Increasing Demand • 4% year on year increase in demand for emergency services • 3% year on year increase in emergency admissionsWhy Ambulatory Care? • Support inpatient admission avoidance • Supports early discharge • Improved patient experience • Research would show that patient’s prefer not to be admitted to hospital due to the periods of perceived inactivity • Provides more efficient care by focusing resources on faster turnaround ie rapid access to diagnostics etc, without compromising patient outcomes.The beginning of the Cardiac Centre • The ambulatory heart failure service provides patients with IV diuretic treatment in order to prevent a hospital admission • Patients receive a daily review and typically spend two to three hours each day in the unit. Benefits include: • Reduction in hospital admission • Supporting early discharge • Education of Patients and carers • Support for patients with heart failure as their condition advances • Enhance patient self managementThe beginning of the Cardiac Centre - 2018 • The ambulatory heart failure service provides patients with IV diuretic treatment in order to prevent a hospital admission • Patients receive a daily review and typically spend two to three hours each day in the unit. Benefits include: • Reduction in hospital admission • Supporting early discharge • Education of Patients and carers • Enhance patient self management • Support for patients with heart failure as their condition advancesCardiac Centre The Cardiac Centre provides a modern patient focused model for the delivery of Cardiology services for our patients. Patients receive same day access to cardiac investigations and medications avoiding multiple attendances to the Emergency Department and also prevents unnecessary hospital admissions.Cardiac Centre – ED Same Day Assessment 2 0 2 1 J a nua ry 6 0 2 0 2 1 Fe brua ry 5 7 90 2 0 2 1 M a rc h 7 4 2 0 2 1 April 80 4 5 2 0 2 1 M a y 6 3 70 2 0 2 1 J une 8 2 60 2 0 2 1 J uly 5 0 50 2 0 2 1 Augus t 5 4 40 2 0 2 1 S e pte m be r 5 0 30 2 0 2 1 O c tobe r 3 4 20 2 0 2 1 Nove m be r 6 9 10 2 0 2 1 De c e m be r 3 9 2 0 2 2 J a nua ry 6 1 0 r r h r a e l s e e e e r r h r a e l 2 0 2 2 Fe brua ry 1 8 u u a A M J J g b o b b u u a A M J J a b M A t c e e a b M 2 0 2 2 M a rc h 2 4 J F e O o e J F S N D 2 0 2 2 April 2 5 2 0 2 2 M a y 3 2 2021 2021 2021 2021 2021 2021 2021 2021 2021 2021 2021 2021 2022 2022 2022 2022 2022 2022 2022 2 0 2 2 J une 2 2 2 0 2 2 J uly 2 3 S um : 1 0 2 2LVH Cardiac Centre • Cardiology Inpatient Bed Day Cost (LVH) - £722 • In 2021 - 677 same day assessments • LOS 2 days (Estimate) – 1354 bed days saved Cardiac Centre – 2021 Data Appointm ent Year Appointm ent M ontFul M othe)viewTotal 2021 January 100 6 106 February 103 12 115 160 M arch 119 25 144 April 82 17 99 140 M ay 106 6 112 June 133 16 149 120 July 83 11 94 100 August 64 6 70 September 64 23 87 80 O ctober 61 27 88 New November 94 20 114 60 Review December 88 4 92 40 Total 2021 1097 173 20 Appointm ent Year Appointm ent M ontFul M othe)viewTotal 0 2022 January 83 17 100 r r h r a e l s e e e e u u a A M J J g b o b b February 60 9 69 a b M A e c e e M arch 44 12 56 J F p O o e S N D April 50 10 60 M ay 69 3 72 2021 June 45 5 50 July 34 0 34 2022 385 56SJA Regional Manager#SASbyChoice
