15 Nov 2012

Hayley Fullerton death: where next for the hospital?

The death of Hayley Fullerton at the age of just 13 months in Birmingham Children’s Hospital was tragic.  Meeting her mother Paula Stevenson and Hayley’s grandfather Edward Stevenson was humbling.  They have fought so hard to have what happened to her recognised and they want changes made.

Outside the inquest on Wednesday, Paula gave an impassioned speech without notes about what she thought of the hospital and the system, which so seriously let her daughter down and which she claims directly led to Hayley’s death.

The hospital trust did not put anyone up for interview but they did release a statement saying they had taken steps to learn from what happened and had made improvements (see previous blog).  What they did not say in their press release was what these improvements have been.

So, we asked them and late yesterday they sent through the list.  I do not know if these changes are what the family had in mind or, indeed if they will work, but I reproduce them here in full.  It would, of course,  have been far more preferable if the hospital had been prepared to go on camera and talk through some of this.

“The main elements we have implemented since Hayley’s death as follows (in no specific order):

1.       Enhanced training for junior doctors on the monitoring and escalation of clinical care to intensive care

2.       Introduced ward based simulation training for nurses

3.       Enhanced how the cardiology medical and surgical team function on a daily basis

4.       Launching the PACE rapid response team January 2013 (extended info on this below)

5.       Added an additional layer of safety into the Hospital at Night Bleep IT system enabling parental concerns raised out of hours to trigger a rapid response from the hospital at night team.

PACE background

The Paediatric Assessment Clinical intervention and Education (PACE) team are currently undergoing additional training prior to the launch of the rapid response system at the beginning of January 2013. This will be a 24-hour service to support ward staff in providing additional care to a patient, should it be required. This additional support by PACE will be in conjunction with the consultant in charge of the patient and the intensive care team.

The PACE team support will apply to patients who ward staff feel may be deteriorating, those who do not necessarily require ITU care, or perhaps when a nurse is particularly worried about the condition of a patient. PACE will jointly assess a child pre and post discharge from our Paediatric Intensive Care Unit (PICU), will sometimes be involved in the actual transfer and also any subsequent additional monitoring and observation support that is required. Parents will also be encouraged to escalate any concerns that they may have through the nurse to PACE.

Once the PACE service is up and running and we develop the service further, we will be introducing a direct referral to the PACE team from parents. We are keen to give parents the opportunity to contact the PACE team directly should they have any concerns, rather than through the nurse in charge. The hope is to give all parents coming to the hospital some written information about PACE as well as the number to contact them day or night.

We are also working towards developing a tool which will help to determine the level of parent concern and the appropriate escalation required to senior clinicians at the hospital.”

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