Heartbeat: SMART is the way forward for ED
January 17, 2019
A new process which means A&E patients are seen within the first 15 minutes of their arrival has been hailed a success.
The SMART (senior management, assessment and rapid treatment) process makes sure patients are seen and treated quickly by senior clinicians.
Dr Asif Naveed, Emergency Consultant, explained more to Heartbeat: “We implemented SMART two months ago and it has already helped our emergency departments run more safely, quickly and smoothly.
“Previously, patients needed to register their details with receptionists and would then wait to be seen by a triage nurse followed by a wait for a cubicle. Now, we have a senior nurse at the reception desk to stream patients upon arrival. Based on the streaming criteria, the nurse will direct patients to the most appropriate area within the emergency department, for example they may go to majors, minors, or they go through the SMART process.
“If they meet the criteria to go through the SMART process, they will then be directed to a SMART room where they will see a triage nurse and a senior clinician, who will assess them. The clinicians can order blood tests or an ECG (a test to check the heart’s rhythm and electrical activity), which will be carried out by an emergency care technician (ECT), who sits in the next cubicle. Afterwards, when the tests and assessments are finished, patients will be given a care plan or directed to a more appropriate speciality, such as the ambulatory medical assessment area or their GP.
They may also be discharged directly from SMART.
“This pathway means that patients do not have to wait for cubicles in the main department for an assessment if they don’t need to.”
Taj Virk-Dhugga, Deputy Directorate General Manager for Emergency Care, added: “After two months of implementation, SMART has proved to be an effective system because 84 per cent of patients who would normally have waited for a cubicle in the main department have received rapid assessment through SMART. Since they do not need to go through cubicles, we are saving a minimum of 126 cubicles hours per day.
“This process greatly benefits patients as they are seen by senior clinicians from the beginning of their journey.”
Patient feedback has also been very positive as 100 per cent of patients who completed the survey about their experience with the new system indicated that they preferred SMART. They would also recommend their friends and family to go through the system when visiting A&E departments at our hospitals.