The document discusses plans to expand the emergency department at Worcestershire Royal Hospital. The key objectives are to increase physical capacity to accommodate growing demand and allow the site to function as the emergency center for the whole county. The expansion aims to improve several aspects of patient care including wait times, privacy, experience, and the types of procedures that can be done. It will also help establish an ambulatory emergency care service and improve overall patient flows through the department. The operational model section then outlines the various functions and staffing within the planned new emergency department layout.

1. ED Expansion
Worcestershire Royal
Latest update 18 May 2016

2. key objectives for the project
 To increase the physical capacity within the WRH A&E
Department to safely accommodate the current and
projected growth in demand for emergency attendances:
o from known demographic changes in the local population and
o from the potential for the WRH site to develop further as the
emergency centre for the whole of Worcestershire, thereby
providing a greater degree of resilience than currently exists.

3. Key Benefits (1)
• Improved service resilience;
• A reduction in the numbers of people who wait for
longer than 4 hours in the department;
• Improved patient privacy and dignity and patient
experience;
• A reduced need for patients to be accommodated
in corridors or in ambulances at times of peak
activity

4. Key Benefits (2)
• An increase in the numbers of invasive procedures
which can be carried out in the department;
• The new accommodation will feel more like a MIU
than an A&E department which will improve the
patient experience;
• The establishment of an Ambulatory Emergency
Care “lite” service;
• Improved patient flows

8. Operational Model
Function – Minors exam
Lead – Emp/CB
What (role & responsibilities)- Assess Pt
When- 24/7
Who - Enp/SN/Clinician
Establishment – Minors Team
Relationships – Dpt/Minors/Xray
Function – Minors GP
Lead - JW
What (role & responsibilities)- Assess
selected Pts
When- 10hrs/day 7/7
Who – GP, 1per shift
Establishment -
Relationships – ED Team/Triage
Function – Minors eye
Lead - CB
What (role & responsibilities)- Eye
Assess + Rx
When- 24/7
Who – Eye Pts
Establishment – Minors/Nurse/Emp
Relationships – Minors/Nurse/Clinical
Function – Minors Treatment
Lead – ENP/CB
What (role & responsibilities)- Assess Pt
When- 24/7
Who – Evp/SN/Clinician
Establishment -
Relationships -
Function – Minors Isolation
Lead - JF
What (role & responsibilities)-
When-
Who -
Establishment -
Relationships -
Function – Minors Plaster
Lead - CB
What (role & responsibilities)-
When- 24/7
Who - Pts
Establishment – In/Out
Relationships – Minors/Nurse/Evp
Function – Waiting
Lead – CB/JW
What (role & responsibilities)- Area Pt
wait
When- 24/7
Who – Triage/Minors/SN
Establishment – 2wte 24/7
Relationships – Reception/Triage/
Minors Enps
Function – Reception
Lead -
What (role & responsibilities)- Booking
When- On arrival
Who – All patients
Establishment -
Relationships – Triage/MC/Wmas
Function – MAU+IA/Xray
Lead -
What (role & responsibilities)-
When-
Who -
Establishment -
Relationships -
Function – Staff Hot desk Office
Lead – Minors/Evp
What (role & responsibilities)- Manage
Support Minors
When- 24/7
Who -
Establishment -
Relationships – Minors staff/Admin
Function – Psychometric, Alcoholic,
Social Work & Discharge
Lead -
What (role & responsibilities)- Assess
specific referred Pts
When- Extend office hours
Who – Referred Pts
Establishment -
Relationships – ED/SS/Outside Agencies
Function – Major Exam
Lead – JW/CB
What (role & responsibilities; Assess and
Rx Patients
When- 24/7
Who – Majors Pts
Establishment – 1:4 RN
Relationships – NIC/TRIAGE/HCAS/
CLINICIAN/SPEC/WMAS/RESUS/
PHARMACY
Function – Adolescent Wait
Lead – BW/CB
What (role & responsibilities)- Teens
When- 24/7
Who - >12 YEARS
Establishment – RN Paeds
Relationships – As Paeds wait 24/7
Function – Staff Base
Lead – JW/CB
What (role & responsibilities)-
Control Hub
When- 24/7
Who – All staff
Establishment – All staff
Relationships - All
Function – ITU STANDARD PC
Lead – (NO CHANGE)
What (role & responsibilities)-
When-
Who -
Establishment -
Relationships -
Function – RAT
Lead - ; JF/LJ
What (role & responsibilities)-
Arrivals
When- 4hrs PM
Who – ST4 + Clinician+ IA Nurse
Establishment -
Relationships – Resus/MC/Majors/
Minors
Function – Paeds
Lead – BW,CB
What (role & responsibilities)- Assess/
Rx <16s
When-24/7
Who – PAEDS RN
Establishment -
Relationships – MC/Triage/RESUS/
Clinicians/Paeds/Specialities
Function – Paeds Wait;
Lead - BW CB
What (role & responsibilities)- <16s
awaiting assessment
When- 24/7
Who - RESUS
Establishment -PAEDS RN/ COVERING
PAEDS area
Relationships – RECEP/NIC/TRIAGE
Function – High Care
Lead – JF,CB,DSM
What (role & responsibilities)- RESUS
Step down, Major step up
When- 24/7
Who – Critically unwell, not req Resus
Establishment -
Relationships – MC Patient Clinician,
Specialities, RESUS
Function – Ambulance Reg;
Lead - Matron
What (role & responsibilities)-
AMB Offload/1.4/CAD/Escalate
When- 24/7 7/7
Who – AMB Conveyed Pts
Establishment – I SN 24/7
Relationships – WMAS,NIC,Patient
Resus Corridor Nurse, Relative
Function – CDU
Lead - JF
What (role & responsibilities)- 24hr
stays
When- 24/7
Who – Criteria Spec
Establishment – 1+1 (RN+HCA)
Relationships – MC/Pharmacist/RRN/
PF/Specialities/Hub/Clinic/Transport
Services
Function – MAU
Lead - JR
What (role & responsibilities)- Ass
Medical
When- 24/7
Who – All Medical
Establishment -
Relationships – AEC/ED/Wards/
Radioligy/GP’s/Specialities
Function – Teaching MH + MP
Lead – BW/JF/CB
What (role & responsibilities)-
EDUCATION
When- As required
Who – All staff
Establishment – MH+MP
Relationships – All staff
Function – Resus
Lead – JW/CB
What (role & responsibilities)-
When- 24/7
Who – 2 SN + Clinician as req
Establishment -Rest Dpt +
Relationships -
Function – Triage
Lead – CB/JW
What (role & responsibilities)- Assess/R
When-24/7
Who – Paeds NIC RESUS
Establishment -
Relationships – MC/Triage/RESUS/
Clinicians/Paeds/Specialities/
RN+ENP+RN (Fwx)(MINORS)

9. Existing Waiting room

10. New Waiting room

11. Reception

12. Visit again soon for another update