SWASFT remote clinical decision making (RCDM) module evaluation

The clinical decision making software used by emergency services and out of hours hospital settings plays a major role in reducing clinical risk and supporting positive patient outcomes. But could the risk adverse nature of many of these computer-based systems lead to inappropriate ambulance dispatch and unnecessary hospital admissions?

A recent NHS 111 focus group explored the effectiveness of telephone triage systems. They identified that, despite using generic software packages, some clinicians were more effective than others in providing the appropriate ambulance dispatch. In fact, clinicians with high closure or referral rates often attributed their success to confidence and competence gained through years of direct face-to-face patient contact.

The increased use of telephone triage across many urgent care settings has seen an increase in workforce demand, but not all clinicians working in remote clinical triage have extensive experience. Therefore their skills need to be developed while in post.

There is a growing need for clinicians working remotely from the patient in areas such as 999 clinical hubs, GP out-of-hours or NHS 111 services, to develop professionally. The University of the West of England and the South Western Ambulance Service NHS Foundation Trust (SWASFT) have worked together to create an education module called remote clinical decision making (RCDM). It aims to give clinicians new to this area of practice, the insight and confidence to apply clinical reasoning alongside computerised clinical triage systems, in order to arrive at the best action for the patient.