SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Diagnostics
7.14.3 Streaming, registration and initial assessment
Figure 7.35 UCC Streaming, registration and initial assessment process
ED Service
(ambulance)
UCC Service
(walk-in)
Registration
Clinical triage
GP reg.
service
Registration &
streaming
Initial assessment
Positive
re-direction
pathway
Unscheduled
care for major
illnesses and
injuries (‘A&E
majors’)
Unscheduled care
for patients with
urgent care needs
who can be treated
in a primary care
environment
Discharge to GP
Referral to Community
Services
O/P referral in line with local
processes
As part of the streaming, registration and initial assessment process, the following activities
will take place:
Patient streaming to the most appropriate service based on clinical assessment of
need, including redirection to community services if appropriate
Patient registration on the appropriate IT system
Initial assessment of patient by an experienced primary care clinician or experienced
nurse
Analgesia and ordering of X-ray, if appropriate.
The E&UC CIG recommends the following key features:
Figure 7.36 Recommended key features
Streaming, registration and initial assessment key features
Single, integrated reception for self-presenting patients – UCC will be patient‟s single point of
access to ED services.
Patients will be clinically streamed to appropriate areas by a GP or experienced nurse.
Patients self-presenting at UCC with major emergencies will be identified immediately by the
streamer and, when appropriate, accompanied to the ED by a doctor or nurse.
Patients arriving by ambulance will access services via the ambulance entrance. The default
pathway for ambulance patients is direct to the ED, bypassing the UCC. However, patients
with minor complaints may be streamed to the UCC by the London Ambulance Service, or by
the ED nurse receiving the patient from the LAS.
Patient details will be captured once on the appropriate IT system at reception – IT processes
7b. Work of the Emergency and Urgent Care CIG 157