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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Development and pilot evaluation of the implementation of a whole-team training pack to improve the effectiveness,
Joseph Clift1, Francesca Helen Dakin1, Anwar Khan2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK.
Abstract:
Remote consulting was rapidly implemented in UK general practice with limited preparation or training. Subsequent research and national investigations have identified patient safety risks. Although evidence-based recommendations and competencies for safer remote care now exist, there is limited guidance on how to implement them in everyday practice.This project aimed to develop, pilot and refine a scalable, whole-team training intervention and to assess its feasibility and acceptability within general practice.Drawing on findings from the Remote by Default 2 study and national patient safety investigations, we co-produced a vignette-based, whole-practice training package with NHS (National Health Service) Resolution and the Health Services Safety Investigations Body. Seven fictionalised patient safety cases were developed to reflect common risks in remote care and were designed to be worked through by practice teams using their own systems and processes. Training was delivered to six general practices across the UK in facilitated sessions lasting 1-2 hours. Anonymous staff feedback was collected immediately after training, with additional reflective feedback obtained several weeks later to support iterative refinement.Sixty-seven staff participated, including clinicians, managers, receptionists and administrative staff. Feedback suggested that the case-based format was engaging and supported whole-team reflection on how remote care systems operate in practice. Participants valued the focus on practice systems rather than individual performance and reported perceived increased awareness of safety risks associated with remote consulting. Equity-related issues featured prominently, with teams reflecting on how remote access and triage processes may disadvantage some patient groups and identifying potential system changes, such as prioritising face-to-face assessment or updating vulnerability registers.This study has demonstrated the feasibility and acceptability of whole-team, systems-focused training to support safer remote general practice.
