Optimising emergency care in a primary care network

Emergency care is a primary care challenge, where low-frequency, high-acuity events require safety and excellence. Enhancing these services aligns with organisational values and Care Quality Commission (CQC) standards. This project sought to identify and address gaps in care delivery, stock management, and staff training for the 90 000 patients and 300 staff of all seven Brownlow Health primary care network sites in Liverpool, England.

To improve emergency care delivery across Brownlow Health for patient benefit.

Structured interviews were conducted with stakeholders, site checks performed, and reflective practice considered. A fishbone diagram was used for root-cause analysis across domains of environment, methods, clinical guidelines, equipment, and people. A driver diagram outlined change theories focusing on aligning protocols with authoritative guidance, staff development, and resource availability. Plan-Do-Study-Act cycles guided implementation. Digital stock check processes were established for ongoing audits.

Emergency protocols were developed and distributed. Emergency bag stock was revised. Educational meetings received positive feedback. Subjective results included increased awareness of emergency procedures, increased confidence to follow guidelines, and improved knowledge of equipment locations. Audit data demonstrated improved protocol access and training uptake. Clinician oversight ensured stock and clinical checks. Digital processes objectively improved stock control and pharmacy supply. Change embedded by establishing monthly managerial site visits.

This project successfully embedded emergency care enhancements, fostering staff engagement and CQC alignment. Key learning is that pursuing unexpected root causes and leveraging broad stakeholder engagement can have expansive impact. Future annual reviews facilitated by digitalisation will likely sustain improvements.