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Quality in Emergency Care Committee (QECC)

Quality in Emergency Care Committee (QECC)

Quality in Emergency Care Committee (QECC)

Quality in Emergency Care Committee’s remit remains very much embedded in the College’s strategics aims.

The Committee has a clear remit to:

  • Develop and review guidelines for the specialty of emergency medicine
  • Develop Consensus Based Best Practice Statements for the speciality of Emergency Medicine
  • Set and monitor standards of Clinical Care, Best Practice and Clinical Procedures in Emergency Departments
  • Produce quality improvement tools for Emergency Departments that will encourage uniform data collection and enable QIPs to be conducted in a systematic way
  • Develop and disseminate patient safety strategies for the speciality of Emergency Medicine
  • Develop and maintain the Quality section of the Royal College website
  • Consider requests for RCEM endorsement from other organisations
  • Consider requests regarding surveys of the membership from other organisations, along with the Research Committee
  • Liaise with other organisations (including other medial royal colleges) regarding issues relevant to the practise of emergency medicine.

The Quality in Emergency Care Committee (QECC) is part of the RCEM Quality Cluster. A small steering group of Sub-Committee Chairs meets twice a year and there are two large committee meetings each year for all QECC members. The committee is currently chaired by James France. The Quality in Emergency Care Committee consists of a number of diverse Sub-Committees, Special Interest Groups (SIGs) and Professional Advisory Groups (PAGs), as shown below.

The current QECC Chair is James France.

Sub-Committes, Special Interest Groups and Professional Advisory Groups

+ Best Practice Subcommittee

Best Practice Subcommittee

The Best Practice Sub-Committee (BPC) produces guidelines where clinical evidence is limited, but where there is a perceived clinical need by members / fellows. This work is almost unique amongst medical royal colleges. The Best Practice Sub-committee also oversees the work of  the following Specialist interest groups (SIGs).

  • Older Person SIG

Provides advice and guidance on issues relating to older persons attending the emergency department (ED). SIG activity includes holding study days.

  • Public Health SIG

Provides advice and guidance related to public health and health inclusion relevant to the emergency department. SIG activity includes holding study days.

  • Toxicology SIG

Provides advice and guidance on issues related to the treatment and assessment of patients attending the emergency department following exposure to toxic substances.  The SIG is responsible for liaising with the National Poisons Information Service regarding the antidotes (specific treatments for exposure to toxic substances) that should be held by each emergency department in the UK. SIG activity includes holding study days.

The current Best Practice Chair is Paul Hunt

Current Committee Work

To be confirmed.

Resources

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Quality Improvement and Assurance Subcommittee

Quality Improvement & Assurance Subcommittee

The Quality Audit & Improvement sub-committee is responsible for overseeing the Quality Improvement Projects which are offered to every emergency department in the UK. These quality improvement projects take a specific aspect of emergency department care and aim to improve the quality of care for patients with this condition; the projects run over a period of one to three years.  The work of the sub-committee includes advice on the procurement of the computer platform required to run the national audit programme as well as clinical standard setting and the production of national reports.

The current Co-chairs of QI&A are Fiona Burton & Dale Kirkwood

Current Committee Work

To be confirmed.

Resources

To be confirmed.

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Mental Health Subcommittee

Mental Health Subcommittee

The Mental Health Sub Committee role is to produce advice on how to look after patients in Mental Health Crisis. Keeping these patients safe and ensure they are treated with respect and dignity.  We work closely with the other Royal Colleges, services such as the Police, Paramedics and Social Care to try and improve access to support with in the emergency department and the community.

The current Mental Health Chair is Mark Buchanan

Current Committee Work

To be confirmed.

Resources

To be confirmed.

Mental Health

RCEM has an active Mental Health Committee whose role is to produce guidelines and resources to equip RCEM members and fellows, with the aim of improving care, safety and patient experience for patients with mental health problems. We also do advocacy and liaison work with other National bodies including other royal colleges, the college of policing, and the CQC.

RCEM learning. There are some great podcasts and learning modules.

RCEM Advocacy

Mental Health services for children and young people (CYP) in crisis in the Emergency Department (ED) have long been a concern for staff, patients, and carers. Children, young people, and their carers often have few alternatives than to come to the ED when in crisis, even those already being cared for by CAMH services. RCEM conducted a survey of availability of services for this group of patients in UK Emergency departments in 2018, and repeated it in 2020 to assess progress since then. Bother surveys can be found below.

National Reports

Useful Organisations and web resources

Mental Health Newsletters

Previous updates to mental health leads about what is happening in Emergency Mental Health Nationally and at RCEM.

How is your ED doing on mental health?

This quiz will take you 2-3 minutes, just to get you thinking.

Do you have a system for mental health triage in your ED?
This is the probably the most important intervention to improve safety for mental health patients. Who trains your nurses to do this? (Hopefully your liaison team are fully engaged with this!) See toolkit for ideas.

Do you have a process for observing those patients that you are most concerned about leaving the ED or self-harming?
Often health care assistants take this role, do you ever speak to them about patients to ask what they have observed? Can you work together to help the patient feel safe and well cared for? HCAs often report not knowing what to say or look for with some patients. Do you have any resources for patients to reduce anxiety? E.g. mindfulness exercises, colouring, soduku, etc?

Do you know your local 24/7 mental health crisis phone number (most introduced since Covid) to give to patients that may need help?
NHS urgent mental health helpline (England only)

Can you name any or all of the Liaison Psychiatry / Crisis team nurses and doctors that see patients in your department?
Try a charm offensive, get to know them, learn from them, get feedback from them.

Are you ever aware of poor staff attitudes towards patients with mental health problems who attend frequently?
Could you challenge these attitudes and be the patient’s advocate?

Have you ever had these attitudes yourself?
Ask yourself why? Were you tired? Annoyed at the system? or perhaps not had / taken the time to find out why this patient landed in the ED and how they feel?

If you think you could be an advocate for better services and care in your department, why not contact (or become?!) your ED mental health lead.

RCEM Wellbeing App

The Royal College of Emergency Medicine recently launched the RCEM Wellbeing App to provide Fellows and Members with the tools they need to measure, understand and improve their mental wellbeing. It can be found here.

For queries or more information email mhchair@rcem.ac.uk

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Safer Care Subcommittee

Safer Care Subcommittee

The safer care sub-committee provides advice and guidance on issues relating to patient safety within emergency departments.  The sub-committee works closely with other NHS bodies as well agencies such as the Healthcare Services Safety Investigation Body (HSSIB). The sub-committee produces regular safety bulletins as well as holding study days.

The current Safer Care Sub-committee Chair is Dr Emma Redfern.

Current Committee Work

To be confirmed.

Resources

To be confirmed.

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Older Persons in Emergency Medicine Special Interest Group

Older People in Emergency Medicine SIG

Provides advice and guidance on issues relating to older persons attending the emergency department (ED). SIG activity includes holding study days.

The current OPEM Chair is Rachel Morris

Current SIG Work

To be confirmed.

Resources

Welcome to the webpage of the Special Interest Group (SIG) for older people at the Royal College of Emergency Medicine.

We are very interested to hear from you about projects and ideas you may have to improve the care of older people in our emergency departments.

Older people are increasingly important attendees to UK’s emergency departments. They are a heterogeneous group and many are active and well although a small proportion are frail.

The fact that older people comprise a special group of ED attendees was described some time ago and many of the conclusions are ever more important.
The report from QualityWatch described the complexity in presentation associated with age and its impact on ED attendances.

RCEM was instrumental in supporting the Silver Book project and this SIG is a concerted effort to bring together like-minded people keen on improving quality care for older people in UK EDs through leadership, service improvement, research and education.

The Silver Book II

Resources

Here are links to some websites on Geriatric Emergency Medicine from around the world that demonstrate the excellent work being undertaken on improving older peoples care.

Link to useful academic publications and books:

Contact

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Public Health Special Interest Group

Public Health SIG

Provides advice and guidance related to public health and health inclusion relevant to the emergency department.  SIG activity includes holding study days.

The current Public Health Chair is Fedel Frederico

Current SIG Work

To be confirmed.

Resources

We all recognise how the Coronavirus pandemic has exposed health inequalities and how more so now than ever the relevance of public health and the role we play as emergency physicians in improving the nation’s health, as well as our response to infectious disease control in the emergency department and the wider urgent and emergency care system.

Public health underpins everything we do, even if you do not know it. For example, do you ever get frustrated by seeing the same sort of preventable injuries and illnesses coming through the front door of your Emergency Department (ED)? What about the injured child cyclist? The adult with recurrent alcohol, tobacco, or drug-related illness? Presentations due to failures in under-resourced community and social care systems? People struggling with mental health problems because they have nowhere else to turn? Social deprivation, alcohol, drugs and adverse mental health are inextricably linked and widen health inequalities with higher levels of preventable illness such as injury related to road traffic accidents, cardiovascular disease and infectious disease with lower socioeconomic status. The ED has annual patient-doctor interactions in the tens of millions, but how often do we take the opportunity to think about the “bigger picture”, let alone have a positive impact on it?

The RCEM Public Health Special Interest Group was established in January 2017 with the vision to provide an integrated approach to strengthening the interface between public health and emergency care in order to improve health outcomes for communities. We are currently made up of 6 clinicians and 1 lay member (names below) who hope to achieve this vision through:

  • sharing the vision with health care workers nationally and internationally
  • working with partners in the development of policies, research, training, and clinical practice related to EM and PH
  • fostering an environment that encourages health care workers to pursue their professional interests in this field.

As a Special Interest Group, we have developed partnerships with key stakeholders and been active in education and curriculum development, research and policy and media engagement. Our initial priority area was injury prevention. Our priority for the next three years is health inequalities and preventative approaches in emergency departments. For trainees this is a particularly exciting time as public health is incorporated into the 2021 emergency medicine curriculum and we plan to support you with resources.

Below is a summary of our work in these areas and future plans.

Guidance

  • We are currently developing a ‘how to guide,’ for implementing public health interventions in emergency departments.
  • Because of the key role that public health has in the emergency department, RCEM has recognised the need for there to be a lead in public health within each emergency department. You don’t need to be an expert, just have an interest in improving people’s lives with a public health approach. The job description for this role is here. Please get in touch if you are interested so we can form a network of emergency department public health leads across the UK.

Education and curriculum

  • We have provided expert advice on ‘health prevention and illness prevention,’ as part of the RCEM 2021 curriculum for trainees.
  • We held a session at the Annual RCEM Scientific Conference in 2018 on the importance of public health in emergency care.
  • In 2018, we also brought together a cross specialty group from public health and emergency medicine for a successful study day: ‘A case of opposites attract or more in common?’
  • We are developing an RCEM learning module on public health.
  • We are going to set up a buddying scheme for public health and emergency medicine trainees to work together on quality improvement projects.

Policy and partnership

The following resource has been released by NHS England highlighting 8 urgent points that need to be addressed in order to tackle health inequalities.

  • We collaborated with injury prevention groups and contributed to the National Accident Strategy ‘Safe and Active at all ages’
  • We have worked with Doctors of the World, Faculty of Public Health (FPH), and Lancet Commission on migration, to advocate for the removal of healthcare charging for migrants.
  • Member of the SIG revised RCEM guidance on homelessness and HIV in 2020.
  • We have an agreement in principle to develop a joint RCEM and FPH public health group (delayed due to COVID-19 pandemic).
  • The SIG have developed a set of recommendations for emergency departments on the need to consider public health.

Research and media engagement

Health Inequalities

The Kings Fund summarises what are health inequalities, inequalities in life expectancy, healthy life expectancy, avoidable mortality, long-term conditions, mental ill-health, access and experience of health services, plus pathways to health inequalities, interactions between the factors driving health inequalities.

The Kings Fund regularly update their health inequalities page with topical and interesting articles.

Further health inequalities resources can be found on the Health Foundation Page

The NHS Long Term plan outlined aims and objectives for the NHS over a ten year period. Chapter 2 involved new funded action the NHS will take to strengthen its contribution to prevention and health inequalities.

The Health Foundation commissioned the Institute of Health Equity to examine progress in addressing health inequalities in the UK, 10 years on from the landmark study Fair Society, Healthy Lives (The Marmot Review). The following resource explores the changes since 2010 in 5 key objectives, outlining areas of progress and decline of each as well as recommendations for future actions.

Covid-19 and health inequalities

Research showing the association between the current pandemic and health inequalities has been definitive. The following links highlight just a small selection of key resources describing this association.

The following videos are a great resource for preventing vaccine hesitancy within ethnic minorities:

Notifiable Diseases

Upcoming events

Contact

You can email the Public Health chair: PHChair@rcem.ac.uk, Public Health administrator quality@rcem.ac.uk, or tweet us at @RCollEM and use#RCEMPH.

The group have set up a WhatsApp group to coordinate engagement with public health and emergency medicine colleagues.

Members

Fedel Federico (chair), Dr Kirsty Challen, Dr Najeeb Rahman, Mr Martin Rolph (Lay), Dr Thomas Shanahan, Dr Andy Snell and Dr Olivia Villegas

Staff/self care during COVID19

Help for doctors with more severe current anxiety or depression symptoms now.
BMA – 24/7 counselling service (0330 123 1245)

BMA – counselling and peer support

Papyrus – Hopeline

Resilience and wellbeing

RCEM has put together 2 posters to display in our staff areas with advice about individual and team (herd) wellbeing:

Other resources

Podcasts

Top tips from the podcast:

  • Limit exposure to information on social media, e.g. check it twice per day only
  • Connect with your usual network of friends and family people by phone or social media, check in with people, start using support
  • Maintain normal day to day activity as much as possible, exercise, eat well, sleep etc
  • Anxious thoughts are normal and we cannot stop them coming, but we can either follow them down into a worse place or we can practice taking small breaks, controlled breathing and focussing on a small absorbing task.

Mindfulness apps

  • Headspace – main website
  • Calm
  • Sleepio– free access for all NHS staff throughout the COVID-19 response
  • Daylight– free access for all NHS staff throughout the COVID-19 response

Advice

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Toxicology Special Interest Group

Toxicology SIG

Provides advice and guidance on issues related to the treatment and assessment of patients attending the emergency department following exposure to toxic substances.  The SIG is responsible for liaising with the National Poisons Information Service regarding the antidotes (specific treatments for exposure to toxic substances) that should be held by each emergency department in the UK. SIG activity includes holding study days.

The current Public Health Chair is Rizwan Riyaz

Current SIG Work

Tbc – chair

Resources

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Emergency Preparedness, Resilience and Response Professional Advisory Group

Emergency Preparedness, Resilience and Response PAG

The EPRR PAG provides expert advice to the College on matters relating to major incidents; CBRNE (Chemical, Biological, Radiological, Nuclear, and high yield Explosives) incidents and other EPRR specialist incidents. It liaises with various national bodies including NHS England, NARU and UKHSE.

The current chair of EPRR PAG is to be confirmed.

Current PAG Work

To be confirmed.

Resources

Details to follow.

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Paediatric Emergency Care Professional Advisory Group

Paediatric Emergency Medicine PAG

The group has a wide remit with representation from other paediatric interest groups, committees and colleges.  Its objective is to assist the college with its position on issues relating to paediatric emergency medicine.  It also aims to provide practical advice and guidance to members and fellows of the college.  The group also collaborates with other groups both within and external to the college on projects relating to paediatric emergency medicine.

The current chair of PEM PAG is Rob Stafford.

Current PAG Work

To be confirmed.

Resources

Details to follow.

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk

+ Pre-Hospital Emergency Medicine Professional Advisory Group

Pre-Hospital Emergency Medicine PAG

Prehospital Emergency Medicine (PHEM) is a GMC recognised subspecialty of Emergency Medicine and a number of RCEM Members and Fellows work in the prehospital setting on air ambulances, as first responders, or in community emergency medicine schemes. The Professional Advisory Group provide advice on issues relating to the prehospital care of patients before they arrive at the Emergency Department. This includes collaborating with other prehospital organisations, developing guidelines and quality improvements, supporting career advice for PHEM and holding educational study days.

The current chair of PEM PAG is Caroline Leech

Current PAG Work

To be confirmed.

Resources

Details to follow.

Contact Details and Committee Vacancies

For further information please contact Quality@rcem.ac.uk



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