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KIDS Annual Report 2014/15 2
REFERRAL HOTLINE 0300 200 1100
www.kids.bch.nhs.uk
@BCH_KIDS
KIDS Annual Report 2014/15 3
TABLE OF CONTENTS
Introduction
Highlights of 2014/15
Mission Statement
Service Standards
KIDS Organisational Structure
Personnel
Activity
Geographical Location of Referring Hospitals to KIDS 2014/15
Summary of KIDS KIDS Activity 2014/15
WM Hospital Referrals to KIDS 2014/15
Out of Region Hospital Referrals to KIDS 2014/15
Referring Department Categories 2014/15
PICANet Groups of Referred Patients 2014/15
Mobilisation, Stabilisation and Duration Times 2014/15
Run Chart – Transport Decision Time to Team En Route 2014/15
Run Chart – Stabilisation Time (Time KIDS team spent at Referring Hospital)
Run Chart – Transport Decision time Arrival at Destination 2014/15
Preference and Destination of KIDS Referrals 2014/15
Clinical Governance
Adverse Incident Reporting
Safety and Care Quality Monitoring
Parent and Child Feedback
Education and Training
Simulation Training
KIDS Annual Report 2014/15 4
Outreach Education
Management and Leadership Developments
Away Days
Regional and National Collaboration
WM Newborn Transport Service
Continuing Professional Developments and External Works
Service Developments
Events and Celebrations
KIDS 5th Birthday Celebration.
Plans for 2015/16
KIDS Annual Report 2014/15 5
INTRODUCTION
KIDS provides paediatric critical care decision support and transport for the West
Midlands. KIDS is hosted by Birmingham Children’s Hospital NHS Foundation Trust
(BCH) in collaboration with University Hospital of North Staffordshire NHS Trust
(UHNS). The service is based at 1, Printing House Street, Birmingham – adjacent to
the main BCH campus.
KIDS serves the 20 District General Hospitals in Staffordshire, Shropshire, Birmingham
and the West Midlands, Coventry, Warwickshire, Herefordshire and Worcestershire.
Two paediatric intensive care units (PICS) operate within the West Midlands – one at
BCH and one at UHNS in Stoke-On-Trent.
KIDS Annual Report 2014/15 6
HIGHLIGHTS OF 2014/15
2014/15 saw KIDS move into their 5th year of operations whilst it’s host trust, BCH,
went through a period of restructure of its directorates with KIDS moving into the
Directorate of Urgent and Critical Care.
KIDS Clinical Lead Dr. Mary Montgomery was appointed as the Clinical Service
Director for the new Urgent and Critical Care Directorate, Dr. Sanjay Revanna
became the Deputy clinical lead for KIDS, Dr. Intikhab Zafurallah was appointed
into a substantive 50:50 post between KIDS and BCH PIC and the KIDS full time
consultant pool was further expanded with the appointment of two locum KIDS
consultants.
KIDS Lead Nurse Phil Wilson was appointed as the Deputy Lead Nurse for the
new Urgent and Critical Care Directorate with KIDS Senior Sister Emma Bull
being appointed to the post of KIDS Lead Nurse and Sister Sarah Taylor was
appointed as the Senior Sister for KIDS
KIDS Junior Sister Sarah Webb commenced training to be the 2nd full-time KIDS
ANP.
KIDS successfully undertook their first air transfer of a child receiving High Flow
Nasal Cannula O2 respiratory support.
KIDS presented one poster and one oral presentation at the Paediatric Intensive
Care Society (PICS) conference, in Newcastle.
KIDS trained 6 new transport nurses and 12 new transport team leaders
(doctors/ANP’s).
KIDS and BCH IT won a ‘Highly Commended’ Award at the Building Better
Healthcare Awards in November 2014 for the Openscape Xpert
Telecommunication system used in KIDS operations centre.
KIDS Annual Report 2014/15 7
KIDS Mission Statement
To provide the right solution, at the right time, and in the right place, for babies,
children, and young people and their families with critical care needs throughout the
region, with timely high quality decision support, PIC bed finding and critical care
transport.
KIDS Annual Report 2014/15 8
KIDS Service Standards
1. KIDS will comply with the Paediatric Intensive Care Society Standards (2010) –
‘Retrieval and Transfer of the most critically ill children.’
2. KIDS will maintain core infrastructure operational 24 hours per day, 365 days of
the year, including:
i. Operations Centre staffed with trained administrators and dedicated single
referral telephone number;
ii. Trained Transport Team;
iii. Fully maintained transport equipment, drugs and disposables.
3. On-site dedicated bespoke critical care ambulances and trained drivers
4. The referral line will be answered within 5 rings
5. The referrer will be connected to the KIDS Consultant within 5 minutes
6. KIDS will comply with the appropriate policies and procedures of BCH
7. KIDS will participate in all care quality surveillance and improvement processes
including clinical governance, mandatory training, infection control,
documentation, child protection and patient experience
8. KIDS will use standard operating procedures (SOPs) for informing service
delivery. These will be held on the KIDS Intranet, with indexing & version control
9. The KIDS website will be maintained with service information, clinical guidelines,
drug calculator and feedback mechanisms in place
10. KIDS will maintain close working relationships with PIC at BCH and UHNS;
11. KIDS will relentlessly pursue continual improvements in the delivery of best for
patients and families. This will include care quality, patient experience, capacity
management, medicine, nursing, administration, ambulance provision,
information technology, telecommunication, research, innovation, risk
management, education, leadership and customer service.
KIDS Annual Report 2014/15 9
KIDS ORGANISATIONAL STRUCTURE
KIDS
(BCH Urgent & Critical Care
Directorate)
KIDS Clinical
Lead
KIDS Senior
Sister
Administration
Team Leader
Sessional
Consultants
KIDS Registrars
& Fellows
KIDS Consultants
KIDS Lead Nurse
KIDS ANP
Rotational
Nurses
KIDS Junior
Sisters/Charge
Nurses
KIDS Volunteer
Call Centre
Administrators
SJA Team Leader
KIDS ANP
Trainee
SJA Technician’s
KIDS Annual Report 2014/15 10
KIDS Personnel 2014/15
KIDS Consultants
Dr Mary Montgomery(Clinical Lead)
Dr. Sanjay Revanna
Dr. Intikhab Zafurallah
Dr. Aravind Kashyap
BCH Sessional Consultants
Dr. Annemieke Miedema
Dr. Richard Neal
Dr. Barney Scholefield
Dr. Gale Pearson
Dr. Fiona Reynolds
Dr. Dave Ellis
Dr. Steve Cray
Dr. Tina Newton
Dr. Afeda Ali
Dr. Linda Edward
Dr. Reinout Mildner
Dr. Jane Cassidy
Lead Nurse
Phil Wilson
Senior Sister
Emma Bull
KIDS Junior Sisters (B6)
Kelly Robinson
Jackie Somerfield
Joanne Webb
Sarah Taylor
BCH PIC/KIDS Junior Sisters/Charge Nurses (B6)
Sarah Webb (up to Sept 2014)
Rebecca Fry
Sharon Hale
BCH PICU Rotational Staff Nurses
(B5)
Louise Kelly
Kate Evans
UHNS PICU Rotational Junior Sisters
(B5/6)
Sue Dodd
Candi Martin
Rebecca Middleton
Elizabeth Lloyd
Leanne Lovatt
KIDS Annual Report 2014/15 11
UHNS Sessional Consultants
Dr. Mark Bebbington
Dr. Pavanasam Ramesh
Advanced Nurse Practitioner
Anneke Gyles
Advanced Nurse Practitioner Trainee
Sarah Webb (Sept 2014)
Advanced Nurse Practitioner (PICU)
Steve Cossey
Rachael Morrison
KIDS Fellows / Registrars
Dr. Damien Keene
Dr. Sanjay Swamy
Dr. Neil Crooks
Dr. Claire Bosanko
Dr. Medha Chillal
PICU Registrars / Fellows on rotation
Dr. Rizwan Saxena
Dr. Jarrod Cross
Dr. Shri Alurkar
Dr. Mark Russell
Dr. Manu Sundarum
Dr. Guru Venkatesha
Dr. Edgar Brincat
Dr. Georgina Harlow
Other Fellows / Registrars
Dr. Danni Seddon
Dr. Jeremy Tong
Dr. Balazs Fule
Dr. Ashwath Rao
Dr. Andrea Cooper
Dr. Gan Chin Seng
Dr. Chris Flannigan
Dr. Richard Browne
Dr. Janet McCluskey
Dr. Vishnu Meedimale
KIDS Annual Report 2014/15 12
KIDS Operations Centre
Call - Centre Team Leader (B4)
Hayley Osmani
KIDS Governance Support Administrator
(B4)
Yasmin Powell
Administrators (B3)
Richard Murphy
Lorraine Rooker
Sarah Casey
Mathew Weir
Christopher Rodgers
Emma Robson
KIDS Volunteer
Pam Kumar
St John Ambulance Services Operations
Manager- West Midlands Region
Samantha Fawcett
Ambulance Technicians
Darren Elgerton
Jayne Wilson
Christiaan May
Paul Colton
Mathew Phillips
Pawel Luczak
Kevin Haggett
Margaret Herbert
Ray Edwards
Dylan Jones
Phil Bone
Alan Jinks
William Byrne
Phil Sprigg
KIDS Annual Report 2014/15 13
Activity
Geographical Location of Referring Hospitals to KIDS 2014/15
Summary of KIDS Activity 2014/15
Location of referral
No.
West Midlands Hospitals 1211
Out Of Region Hospitals 153
Total Referrals 1364
Outcome
No.
KIDS Transfer 627
NTS Transfer 179
CNN Transfer 9
Referring Team Transfer 108
Other Team Transfer 46
Not Transferred 395
Total Referrals 1364
KIDS Annual Report 2014/15 14
West Midlands Hospital Referrals to KIDS 2014/15
KIDS Annual Report 2014/15 15
Out of Region Hospital Referrals to KIDS 2014/15
KIDS Annual Report 2014/15 16
Referring Department Categories 2014/15
PICANet Groups of Referred Patients 2014/15
0 50 100 150 200 250 300 350 400 450
Liver
Body Wall/Cavity
Blood OR lymph
Multisystem
Trauma
Other
Cardiovascular
Respiratory
PICANet Groups of Referred Patient 2014/15
KIDS Annual Report 2014/15 17
Mobilisation, Stabilisation and Duration Times 2014/15
Run Chart – Transport Decision Time to Team En Route 2014/2015
Times Lower IQR Median Upper IQR
Referral to Acceptance 00:13 00:35 03:51
Acceptance to Mobilisation 00:09 00:15 00:45
Acceptance to Arrive DGH 00:32 00:50 01:31
Stabilisation 01:11 01:41 02:28
Total Episode 03:35 05:02 06:40
KIDS Annual Report 2014/15 18
Run Chart – Stabilisation Time (Time KIDS team spent at Referring Hospital)
Run Chart – Transport Decision time Arrival at Destination 2014/15
Preference and Destination of all KIDS Referrals 2014/15
BCH = Birmingham Children’s Hospital
UHNS = University Hospital North Staffordshire
UHL = University Hospitals of Leicester
NUH = Nottingham University Hospital
QMC = Queens Medical Centre
OOR = Out of Region
Referrers Preferred Destination
Actual Destination
West Midlands East Midlands
Other Total
BCH UHNS Other West Midlands
UHL QMC Taken OOR
Not Transferred
BCH 444 35 11 8 3 15 17 533
UHNS 3 70 0 0 0 1 3 77
UHL 0 1 0 8 0 0 0 9
NUH 0 0 0 0 2 0 0 2
Other West Midlands
4 1 119 2 0 1 3 130
OOR 1 0 1 0 0 46 5 53
No Preference 49 81 22 2 3 18 385 560
Total 501 188 153 20 8 81 413 1364
KIDS Annual Report 2014/15 20
Clinical Governance
Adverse Incident Reporting:
KIDS continues to report using the incident reporting system at BCH.
Threshold for incident reporting is low – resulting in high volume of incidents
reported (One of the highest in the Trust, despite small size of KIDS). This
reflects healthy reporting culture, and is encouraged. Incidents are reported as
relating to KIDS team (equipment/communication/clinical and other) or
relating to referrer activities. Management of the non-KIDS incidents – i.e.
those relating to referrer activities – can be difficult to classify due to the
nature of the reporting system and field designation. KIDS works closely with
the BCH Governance department to assist in clarifying designation as ‘KIDS’ or
‘other hospital’ incidents, and continue to work towards developing a system
for managing ‘non-KIDS’ incidents. Most KIDS incidents have caused no harm
to patients. We have also had no SIRI/ DLR/ never events in the year.
All cases referred are reviewed and discussed by the KIDS team in the morning
meeting. Any issues raised are managed in a timely fashion through the
existing channels (depending on nature of issue: equipment, clinical, team
working, communication). Issues relating to ‘non-KIDS’ activities are fed back
directly to the referring centre through the BCH governance system.
Monthly incident reporting is to the Directorate Management Team, with
scrutiny of patterns or significant incidents. KIDS hold monthly M&M meetings
and attend BCH PIC monthly M&M. Any cases requiring higher level scrutiny
are discussed with the BCH Governance department and appropriately
actioned.
KIDS Annual Report 2014/15 21
Safety and Care Quality Monitoring
In 2014 BCH continued to enshrine the lessons from the Berwick Report, the
Report with the implementation of their new Safety Strategy for 2014-2017.
There was a focus on a pro-active approach to safety with recognition of the
need to engage in human factors training and ensure our systems were robust
and regularly reviewed.
KIDS continues to pursue an open and honest governance structure, with a
high level of reporting of incidents. The high level vigilance of KIDS ensures
physical resources are in a state of readiness and that minor deviations of
standard practice are recognised and addressed swiftly.
KIDS framework for ensuring safety and care quality are maintained includes;
Strong, stable management team focussed on effective and progressive
clinical leadership.
Thorough recruitment process – building a skilled, professional,
motivated and stable team.
Comprehensive training and annual reaccreditation.
KIDS Standard Operating Procedures available on BCH KIDS Intranet Site
Well-resourced and effectively managed equipment store, with on-line
manuals, teaching packages, repair and maintenance plans empowering
all staff to address problems.
Equipment checks, vehicle checks, operations centre checks monitored.
Audit of Critical Incidents, KIDS risk register and serious incidents.
Audit of Mobilisation, stabilisation, transport duration times and ‘blue
light’ usage.
Implementation of all BCH care quality surveillance monitoring; Infection
Control, Child Protection, Documentation, Patient Experience and
Referrer Experience.
KIDS Annual Report 2014/15 22
Parent and Child Feedback - Child and Family Steering Group
KIDS continued to gain all types of feedback received from patients and
parents, in order to gain a more critical insight of the issues they face when
their family experiences a critical care transport.
Some examples of feedback received from parents;
“In the ambulance with the phone charger I was able to reply to the hundreds of texts I
was getting from everyone about what was going on! Really glad you let us both travel &
we hadn't eaten for hours. So thanks for the Ribena & Chocolate.”
“They were totally amazing! They spoke to us lovely & so kind! They seemed really
bothered about our comfort. They were so reassuring, that they knew what they were
doing! The drink and snack was so needed. Dairy Milk just perfect! For a stressed mum!”
“The offer of the Sat Nav was good. The team helped us in this stressful time for us.”
Themes within feedback received during the year 2014/15 were, by far the
most frequent, about the parent snack packs (that were introduce in the year
2013/14 on the back of parent feedback), the phone charges in the
ambulances (again introduced in 2013/14 as a result of parent feedback), the
professional manner of the KIDS team and their calm and caring natures.
KIDS Annual Report 2014/15 23
Education and Training
KIDS trained and signed-off 12 new clinical team leaders (12 registrars/clinical
fellows and 1 PIC ANP) and 6 nurses in transport during 2014/15. This was
achieved through in –house study days and 1:1 training from KIDS consultants
and senior nurses.
KIDS continues to provide placements for other healthcare students and other
healthcare professionals (doctors, nurses and paramedics) to observe the KIDS
team at work. Feedback remains positive about KIDS as a learning
environment for paediatric transport, service coordination and team-working.
Demand for places continues to rise.
Simulation Training
Dr Zafurallah leads on delivery of the simulation programme. The high fidelity
SimBaby owned by KIDS is used for training of staff at KIDS and throughout the
region. It is an effective tool for delivery of real time scenarios. Dr Zafurallah
and a team of KIDS nurses trained in simulation use SIM frequently to delivery
training around human factors and crew resource management, improving
team working in complex and stressful environments. This training is not only
provided for KIDS team members but also for those in the region.
Outreach Education
KIDS has, within its available resources, delivered outreach education to many
of the district general hospitals (DGH) across the region. Requests for outreach
education are regularly received and are commonly cited on the ‘feedback
questionnaires’ received from hospitals after each transport.
The ‘Stabilisation of the Sick Child’ study day was led by the KIDS team at at
BCH upon 2 occasions during 2014/15 to a multidisciplinary audience of
doctors and nurses from WM region.
KIDS Annual Report 2014/15 24
Simulation training in progress
KIDS Annual Report 2014/15 25
Management and Leadership Development
2014/15 saw quite a change in the management structure of KIDS as BCH
restructured.
In October 2014 KIDS Lead Nurse Phil Wilson was appointed to the position of
Deputy Head of Nursing for the new Urgent and Critical Care Directorate
following the restructuring of its directorates.
In January 2015 KIDS Senior Sister Emma Bull was appointed to the post of
KIDS Lead Nurse
KIDS Consultant, Dr. Intikhab Zafurallah was appointed into a substantive post
50:50 with BCH PIC.
Away Days
The KIDS Team had a multi-disciplinary away day in November 2014 at the
Thistle Hotel. The theme for the day was the implementation of the Trust
values – with emphasis upon the value of ‘Respect’.
KIDS Annual Report 2014/15 26
Research and Audit
Poster Publications – Paediatric Intensive Care Society Conference (2014) -
Newcastle
KIDS presented one poster publication and delivered one oral presentation at
the Paediatric Intensive Care Society conference which took place in
Newcastle, during September 2014.
KIDS Lead Nurse Phil Wilson delivered the oral presentation, titled, “Customer
Service Theory Improves Patient and Staff Experience in a Paediatric Transport
Service” and won the prize for the best free paper presentation.
KIDS Annual Report 2014/15 27
KIDS Annual Report 2014/15 28
Regional and National Collaboration
WM Newborn Transport Service
The merger project of KIDS and the WMNTS continues.
Continuing Professional Development and External Work
KIDS ANP Anneke Gyles had the opportunity to sit on the working group for
the new ALSG transport course NAPSTaR. Anneke, with input for the KIDS band
6 team contributed 2 new chapters to the course manual.
Service Developments
New switch board and training of the relevant staff
Training of ambulance staff to perform additional roles- arterial flush
system, help with monitoring etc
RCPCH approval for CPD points of our stabilisation day programme
Discussion and set up of the new database system which went on air
from 1 April 2015.
Events and Celebrations
KIDS celebrated their 5th year of service with a ‘Childrens Party’. It was a a fairly
informal affair, held in the conservatory at BCH with party food, children’s
entertainment, face painting and music. Families who KIDS had maintained
links with, including those who have kindly donated money to the KIDS Charity
Fund were all invited, even BCH CEO Sarah-Jane Marsh attended!
KIDS Annual Report 2014/15 29
KIDS 5th Birthday Celebration
Plans for 2015/16
Full merger of KIDS and WMNTS.
Further development of the KIDS ANP team.
Develop outreach teaching to involve ‘in-situ’ simulation.