Hospital emergency care teams: our solution to out of hours emergency care

The implementation of the European Working Time Directive and the compulsory reduction in junior doctors hours provided the main driver and background for this project. The project aim was to implement Hospital Emergency Care Teams (HECT) on three District General Hospitals (DGHs) to provide emergency out-of-hours care. The project strategy centred on the recruitment, training and preparation of critical care nurses to undertake advanced assessment roles. Methods used to monitor and evaluate activity include the use of innovative hand-held computers. Main outcomes include, the conclusion that a multidisciplinary HECT of five could manage the overnight workload and level of acuity in a DGH of 420-500 beds, and that critical care nursing staff can be prepared for advanced supporting roles. Experiences gained provide valuable learning that could be used to influence similar projects. Implications for practice include the development of a national framework to inform areas such as multidisciplinary competency-based education and training. Scientific evidence is required to evaluate the effect of HECT on hospital mortality and morbidity and quantify the staff, inpatient experiences.