*** PLEASE NOTE: Upon Registration, there are some useful documents that you have access to with regards to the 'why?' and the 'what' for Treatment Escalation Plans which will NOT be the main focus of this event. We will aim to tackle TEP implementation - the 'how'. You can find these documents in the Catch Up content ***

Identifying the deteriorating patient is a key element in a patient safety programme. But the response to the deteriorating patient is just as important. Managing out-of-hours emergencies can be difficult for on-call staff. Discontinuity of care is an almost universal problem in delivering emergency care.

Treatment Escalation Plans aim to provides easily accessible information and guidance about what should be done (or not) in the event of deterioration. But a TEP is a complex intervention.

Training and education in two key domains is both necessary and challenging:

• Reframing priorities in medical decision-making. Consultant buy-in and leadership is as important as clinical team participation.
• Discussing and agreeing goals of treatment as well as what should be done (or not) if things get worse. Learning to have a conversation under time pressure involves communication skills development.

Implementing TEPs has multiple component parts:

• Integrating TEPs into existing Deteriorating Patient SOPs
• Training and education for trainee doctors and nurses: essentials that they need to know about TEPs and how to create them.
• Training and education for lead clinicians - convincing them that TEPs are time well and that there are beneficial outcomes that are worth having.
• Choosing appropriate outcome measures for audit and research projects
• Selecting and applying situations in which TEPs are “mandatory” rather than discretionary
• Accountability: incorporating TEPs into Morbidity and Mortality reviews.

The Webinar will offer an exploration of these questions. The emphasis will be on how rather than why. Participants will be actively encouraged to pose questions as well as offer their experiences of what has worked or not worked in addressing problems. The aim is to provide a forum for exchanging ideas and practical solutions.

SCHEDULE

1:30-1:40 | Introduction | Dr Stephen Friar

1:40-2:05 | Treatment Escalation Plans: How to integrate them into a Deteriorating Patient Programme | Dr Gregor McNeill

2:05-2:30 | Treatment Escalation Plans: Mandatory or discretionary? Experience in the Princess Alexandra Hospital | Dr Jane Snook

2:30-2:55 | Getting Treatment Escalation Plans to stick - Experience of Pilot and Audit Projects | Dawn Coventry (Quality Improvement Manager, NHS Lothian), Lise Axford (Chief of Nursing Services, Hairmyres Hospital)

2:55-3:05 | Coffee Break | Go to sessions on the left of your screen and have a coffee with others!

3:05-3:30 | Implementing TEPs in the ED and how to get ED medical staff on board | Dr Calvin Lightbody

3:30-3:55 | Snapshots: communication with patients under pressure; outcome measures and accountability at M&Ms | Prof. Robin Taylor

3:55-4:30 | Panel Discussion and Questions - All