8 Stop-watch care
Matter for discussion submitted by the RCN Lothian Branch
That this meeting of RCN Congress discusses the impact of the four hour emergency care target on patient care and staff morale
Work led by the RCN Public Policy Committee.
Discussion at Congress 2008 focused on the pros and cons of the Department of Health (DH) target that no patient should have to wait more than four hours for admission to a bed, transfer elsewhere or discharge, and whether this would result in clinical decisions that were not in the best interests of the patient. The wide ranging debate at Congress included a plea to extend the target by a further 10 minutes.
The DH has since rebuffed RCN calls for a relaxation of the four hour standard, stating that long waits at A&E are unacceptable and that performance against this standard is widely seen as a good measure of a hospitals' overall management quality.
Although the DH has been reluctant to compromise on the four hour operational standard, it has been very receptive to engaging in further work with the RCN on enhancing the quality of care for patients in emergency care.
The RCN has co-operated with the Emergency Nurse Consultant Association, and has lobbied to raise awareness of the positive and negative potential implications of the four hour target for patient care, staff morale and management behaviours.
The RCN's Emergency Care Association (ECA) contributed to the RCN national dignity campaign Dignity - at the heart of everything we do and launched a set of nine basic emergency care dignity principles developed with the Patients Association - which set out the minimum standards patients can expect when visiting an emergency care department.
A presentation of the findings of the RCN online membership survey (2008) on dignity has been undertaken with the DH A&E stakeholder group, and the RCN is writing to the Secretary of State for Health (England) requesting urgent action on the concerns raised by the survey including data manipulation; inadequate patient care and inappropriate management behaviours.
The RCN has co-operated with the Emergency Nurse Consultant Association, and has lobbied to raise awareness of the positive and negative potential implications of the four hour target for patient care, staff morale and management behaviours throughout the whole health care system.