EmergencyList has distinct roles for clinicians, anaesthetists, theatre staff and ward staff.
The booking clinician is likely to be a junior doctor either working on the wards, or within A&E. The clinician assesses the patient and enters details about the patient and the required procedures, including the patient’s current location, the consultant responsible for care, details of the operating surgeon, the urgency of the operation and if an anaesthetist or radiographer will be required in theatre.
For each required procedure, the specialty is selected, which may cause additional details to be requested, for example:
• General surgery procedures will require the addition of Operative Parameters to help determine morbidity scores; and for further details relating to NELA - the National Emergency Laparotomy Audit.
• Orthopaedic procedures relating to fractures will require further details relating to location and type of fracture, plus additional parameters for fractured neck of femur (NOF) cases in order to determine the Nottingham Hip Fracture Score and to assist in achieving NHS Best Practice Criteria.
• Vascular access procedures will require additional information that will be of use to the surgical team.
Details about the patient’s clinical status, the results of any investigations, allergy details and infection risks are then entered before the case is added.
The specialties available and actual parameters requested can be configured to the requirements of the individual hospital.
When a case is added, it is allocated to the default theatre for the primary specialty, but this can be changed later by the anaesthetist or theatre staff if required.
The booking clinician should call the duty anaesthetist to let them know that the case has been added.
Anaesthetists can login to EmergencyList on any hospital computer and can quickly see which patients are waiting to be accepted or assessed.
They can view and amend case details if required and can indicate that they accept a case. Once they have seen the patient, they can indicate that the patient has been assessed, record the ASA status, add notes and specify whether or not the patient is ready for theatre.
In cases where the predicted mortality rate is calculated to be greater than 10%, a consultant anaesthetist should also be consulted and EmergencyList ensures that appropriate details are entered.
Anaesthetists can amend the order in which cases appear on the main case list, move cases between theatres and add anaesthesia notes if necessary.
Theatre staff can easily see details of all forthcoming cases, which can be filtered by specialty or by theatre. They can view details about individual cases, alter theatre allocation if required, add theatre notes and change the priority of cases on the list.
Theatre staff can indicate when a case goes into theatre and once completed or cancelled, can remove the case from the list adding appropriate notes if required.
Ward staff can be granted access to EmergencyList so that they can see where their patients are on the theatre lists and plan accordingly. For issues of data governance, ward staff can be restricted to seeing only hospital numbers rather than patient names.
System administrators have access to define and update details of theatres, specialties and wards. They can also configure levels of access, system warnings, surgery hours and various other system parameters. System administrators also have access to system reports and a full audit trail showing when and who updated any individual item of data.