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Client Story:  King’s College Hospital

Improving clear, consistent documentation of treatment escalation plans

As part of its commitment to patient safety and quality of care, King’s College Hospital NHS Foundation Trust designed clear, consistent processes to document clinical decisions about resuscitation. It created an electronic tool to capture the clinical resuscitation decisions for each acute patient admission. This consists of a ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) form and treatment escalation plan (TEP), which defines appropriate levels of intervention. The percentage of monthly admissions with documentation of these clinical decisions improved from 18% on paper-based forms to reach nearly 100% with an electronic tool that uses an intelligent Allscripts Sunrise order set.

”There was a nice steep jump in documentation after August 7, 2016, which is when we enhanced the form and implemented Allscripts Sunrise.”

Key Outcomes

  • Percentage of monthly admissions with documented DNACPR and TEP increased from 18% to 100%
  • Clear documentation optimises multidisciplinary communication, particularly amongst intensive care, critical care outreach teams and the ward team
  • After six months, clinicians report feeling more empowered to make early CPR/TEP decisions and nurses feel more confident in escalating care

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