Welcome to the third briefing Getting prepared for our new Emergency Department. Via this newsletter we will share information with you about how the final building work is going and how you can help us prepare for the opening of the new Emergency Department which is on Wednesday 26 April 2017 at 4.00am.

John Adler, Chief Executive

What have we been up to?
There are now only 22 days left until the new Emergency Department opens its doors to the public!
All of the building work is now close to being complete, and contractors are due to officially leave the site on the 3rd April.

In our Paediatric (Children’s) ED the play areas are now being installed. There will be three distinct areas – for toddlers, children and teenagers. One area is shown in the picture, (below)







Staff who will be working in the Major’s area  of the department have also been familiarising themselves with the new bigger space (please see the pictures below). Three sessions a day are being held to ensure all staff are prepared for the changes and new processes which will come from working in the new department.
As well as familiarisation, staff have been doing simulation training to make sure that in an emergency situation they know where all of the equipment they need will be.                                                          






An Emergency Department with a focus on frail older people
When we began designing our new Emergency Department, we were mindful it was crucial it met the current and future needs of the people we serve across Leicester, Leicestershire and Rutland, particularly in light of our ageing population. Over 20% of the patients treated in our Emergency Department are frail and older. Confusion (delirium and dementia) and falls are the commonest frailty presentations and it was important we created an environment that was dementia friendly. This would allow our staff to treat the clinical needs of these vulnerable patients at times which are scary and daunting.

With the build designers Capita, and drawing upon research and expertise, we began to incorporate what we could within the financial envelope. Bringing in experts to the planning process was also important and we worked with stakeholder groups such as Age UK, Vista, our own clinicians and an academic, Professor Andrew Price from Loughborough University. Prof Price has experience of designing hospitals for improving healthcare outcomes. He also led the work for the Department of Health on how to design hospital buildings, particularly dementia friendly builds, which gives guidance on patient friendly design that deliver improved patient care.

Dr Jay Banerjee Consultant in Geriatric Emergency Medicine has had a key role in this process. He said: “Our current Emergency Department is not frailty friendly and was not built with that group of patients in mind. That was something that we needed to change.”

“The new department will have some interesting new design elements. These include rubber flooring in the department rather than vinyl, which is harder to slip on and also helps reduce injuries if someone should fall. The floor design lacks patterns which can also prevent people with dementia trying to pick non-existent “bits” off the floor which they can find distressing. We have used a bright colour scheme and LED frames to give clear demarcation between zones, floors and rooms to help reduce confusion.

We have also thought about the equipment that we use for these patients, such as having trolleys that are lower and easier to get on to and ensuring that monitors, wires and oxygen outlets are behind panels to stop people from harming themselves. Some of this technology is in use in the US and we have gone to the same manufacturers to integrate this technology into our build. We also have purpose-built mental health rooms, where patients will be protected from harm whilst they are being assessed and treated.”

Dr Banerjee continued: “It was also important that we made sure that the right processes and training was in place to enable staff to give the best care for our patients, building on our experiences of treating people in the current department.”

“This can also include minimising the movement of frail older patients and make their management more personalised. This means being more focussed on treating the person and not their condition – balancing care versus cure.”

Much of these new ways of working are part of Better Care Together (the Sustainability and Transformation Plan for Leicester, Leicestershire and Rutland) providing the most appropriate care close to home. Dr Banerjee added: “For example, a patient who has fallen does not necessarily need to go to the Emergency Department, but could be cared for by a GP. We have been working with EMAS to train/ help them better assess whether patients need to come to our Emergency Department or if they could be treated better at home with community support. It is about giving staff the right skills, empowering them to make a decision so that the patient gets the most appropriate care in the most appropriate place and therefore, we need to ensure the system is built to support that decision making.”

So what is Phase 2 of the Emergency Floor?
On Monday 8th May Interserve Construction will take over the old Emergency Department and Urgent Care Centre to begin work on Phase 2 of the Emergency Floor. This is why we need to permanently close the main entrance to Balmoral on Wednesday 26th April when the new Emergency Department opens.
Phase 2 will include the following services:-

  • GP Assessment Unit (GPAU) 8 trolleys and a number of consulting rooms
  • Elderly Frailty Unit (EFU) 16 beds
  • Acute Frailty Unit (AFU) 16 beds (currently ward 33 at the Royal Infirmary)
  • Acute Medical Unit (AMU) 32 beds (currently wards 15 & 16 at the Royal Infirmary)
  • Acute Card Bay (ACB) 10 beds ( currently ward 16 at the Royal Infirmary)
  • Emergency Decisions Unit (EDU) 12 beds

The refurbishment of these areas will start on Monday 8th May 2017 and run through until the 13th March 2018. The area being refurbished is around the same area (metres 2) to the ground floor of the Emergency Floor. Interserve Construction will be setting up their site cabins, materials, skips etc in front of the main entrance, closing it off during construction.

When the project completes the Balmoral entrance will be controlled access ensuring patients attending GPAU and leaving the Emergency Floor by ambulance do so in an appropriate way.

There will be noticeable works outside of the Phase 2 building area, for example, works to create drainage points will affect areas on the ground floor – all affected areas are being reviewed and contact being made to plan to minimise operational disruption.

This work will be complete in Spring 2018.

Did you know…
All the scrap wood generated by the project is being recycled and has been used in projects ranging from the Next Catalogue to fences around children’s playgrounds.
Don’t forget to keep up to date with our Blog: http://newedleics.blogspot.co.uk/