Emergency Care Discharge Summary

Andrew Carr, Clinical Systems Designer, University College London Hospitals NHS Foundation Trust

A member of the RCN's E-health forum and Emergency Care Association, Andrew Carr is a clinical systems designer at University College London Hospitals NHS Foundation Trust, where he is helping to build and adapt an electronic records system for their emergency department

He is also an emergency nurse practitioner with more than 30 years' experience.

I became involved with the Professional Record Standards Body (PRSB) as part of a group helping to develop an emergency care discharge summary. This ensures vital information is transferred quickly to GPs, following a patient's discharge from a visit to the emergency department.

I was able to contribute firstly, as someone who has specific expertise in emergency departments, and secondly, bringing my experience of working with systems that capture data. One of the unique things about my role is that I sit on both sides. I'm a very experienced emergency care clinician, but I also understand how IT systems work in practice.

I feel that I gained a lot from being involved in this project. Being there at the point at which decisions were made that would impact EDs throughout the country meant I was able to exert influence. Working with other clinicians also helped me to find out more about what they really want, rather than making assumptions. For example, we might say to a GP, you can have this piece of information, but they may say, thanks but we don't want it. For us it may be interesting, but for them, it doesn't help. Whether to include information automatically, or ask a clinician to decide, is complex.

Nursing's voice needs to be heard, but sometimes that doesn't happen. Nurses have a unique perspective in that we're with the patient for far longer periods of time than medical colleagues, who tend to have short, intense periods of interaction. But a lot of communication about patients is from one doctor to another, with systems geared up to transmit clinical information, and not necessarily the nursing knowledge that needs to travel alongside it. It's important to demonstrate the value of moving nursing information from one clinical setting to another, including between hospital and the community.

Having been involved in this process, I could make sure that a nursing voice was included, and I think I was the only emergency nurse taking part. With the summary's publication, it's good to think that I helped to achieve that end point.

Andrew Carr
Clinical Systems Designer, University College London Hospitals NHS Foundation Trust

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