On Thursday 7 November 2019, we geared up for a very special annual meeting. As well as our usual programme of updates, case studies and research, we were also celebrating the 10th anniversary of our first patient in. We were delighted to welcome
- 85 Resus officers & clinical staff
- 6 External speakers
- 22 Special guests, NCAA Steering Group members and ICNARC staff
- 4 exhibiting companies
Unfortunately, some of our delegates couldn’t make it due to train cancellations, but those that did enthusiastically joined the discussion.
Kerrie Gemmill, ICNARC’s Managing Director, kicked off proceedings with a spirited welcome and took us through the format of the day. She also introduced our “Networking Bingo” game. Delegates were tasked with talking to as many new faces as possible and completing their bingo card for the chance to win a fabulous (chocolate-based) prize.
Session: 10 Years of NCAA
NCAA Programme Coordinator, Sarah Furnell introduced the NCAA team and took a look back at some of the highlights from the last year. One of the exciting plans unfolding in 2020 will be the development of a new and improved NCAA data collection tool. Some of the proposed updates are dashboards to track progress, task lists to show exactly what tasks are outstanding and a simpler, less repetitive data validation process. Delegates were invited to give thoughts and suggestions via the Slido app and comments box. For those who could not attend, we’d still love to hear from you.
Did we mention it was NCAA’s 10th anniversary? We made a bit of a departure from our usual annual key statistics presentation. ICNARC statistician, James Doidge guided us through some of the data trends from the first (almost) decade of NCAA data. Disclaimer, as the scope of NCAA changed in 2011, trends covered 8 years. Don’t worry the key statistics will be back on the agenda next year, and the 2018/19 report is now available on our website.
Moving on to public reporting, Prof David Harrison, Head Statistician at ICNARC, updated delegates on recent developments, proposed analyses and timelines. It’s been a long road, but the end is in sight. We are working hard toward publicly reporting on 2019-20 data, with a view to publishing the results in November 2020. One area where we would like participants feedback is on the best way to group “similar” hospitals. If you would like to get involved, please contact the NCAA team.
Session: Hospital case studies
This year, we focused on the processes involved in data collection for NCAA.
Tyrone Samuels, NCAA Data Coordinator, explained the evolution of the project and the introduced the concept of the “Data Supply Chain”, the path data takes from the patient’s bedside to the NCAA database. We then heard from three hospitals on different aspects of the data collection processes at their hospitals and some of the challenges that they have overcome.
Kelly Shiel from Nottingham University Hospitals NHS Trust gave an account of her team’s work to standardise post-arrest documentation with the use of a new 2222 medical documentation form. An initial trial last year showed a 60% compliance rate, and it has now been adopted as a trust-wide document, and ongoing compliance is being monitored on a monthly basis.
Luke Jeyes from University Hospitals Birmingham NHS Foundation Trust talked about the need for simple, reliable local systems that people can use to cross reference cases as well as the importance of having good working relationships with the switchboard and critical care outreach teams. But his special tip for data entry… 2 screens!
Zoe Abel from Oxford University Hospitals NHS Foundation Trust spoke about how strong communication is the cornerstone of their data collection process. Nominated Resuscitation Link Practitioners are used to strengthen the relationship between the resuscitation and other departments. Yellow emergency posters in all clinical areas help anyone making a 2222 call to give precise information to the switchboard ensuring that all cardiac arrest calls are responded to appropriately.
We finished the session with Q&A and invited the delegates to share their own challenges and solutions. We would have loved to extend the session, but stomachs were rumbling and lunch beckoned. Presenting at the annual meeting is not the end of this project. We have now published the existing case studies on our website and want to encourage all participants to keep sharing their experiences and ideas.
Lunch was a chance for delegates to stretch their legs, chat with colleagues (and score some bingo points), visit the NCAA helpdesk and our exhibition. This year we extended our exhibition with representatives from Cardiac Services Ltd., Intersurgical, Timesco and Zoll Medical in attendance.
We got quickly back to business, with an introduction to the Royal College of Anaesthetists 7th National Audit Project, by NAP7 Clinical Lead and NCAA Steering Group member, Jasmeet Soar. The focus for NAP7 will be peri-operative cardiac arrest. Over the next few months, work will be done to finalise inclusion criteria and surveys, start building databases and disseminating information, with the aim to start data collection in April/May 2020.
Alexina Mason, Professor of Medical Statistics at London School of Hygiene and Tropical Medicine, started the research session with the results of a survey on resuscitation service provision and its affects on outcomes. Information on service provision was collected from 110 hospitals and linked to outcomes in NCAA data.
Last year, Matt Thomas, Consultant Intensivist from Southmead Hospital, talked about factors leading to arrest in ICU. He noted that there are a lot of gaps in our knowledge and used the analogy of a black hole, once cardiac arrest patients are transferred to ICU, NCAA often can’t access the information inside. This year he returned with an update on a new study which aims to look beyond the event horizon. The Critical Illness Related Cardiac Arrest (CIRCA) study will collect data on all IHCA occurring in the ICU, including those where a 2222 call is not made. Site selection is currently underway. For more information, contact the CIRCA team.
Savvas Vlachos, Consultant in Critical Care Medicine at King’s College Hospital, spoke about a proposed study looking at early withdrawal of life-saving treatment (WLST) after cardiac arrest. The study will use linked CMP and NCAA data to investigate the incidence and variability of early-WLST between ICUs and factors associated with these decisions.
Finally, Jerry Nolan, Chair of the NCAA Steering Group, spoke about targeted temperature management after cardiac arrest and its affect on outcomes. This prompted quite a lot of interest from the floor in the Q&A session. The results are not yet publicly available, but we will be sure to include a link in our newsletter when they are.
The new CEO of Resuscitation Council UK, James Cant, took to the stage to talk about the strong relationship between NCAA and RCUK.
After a day of serious business, it was time for a bit of fun as Sarah Furnell hosted a “How well do you know your NCAA” quiz on Slido. The questions were a mix of NCAA history, scope and dataset questions. As a group, the audience scored a respectable 7 out of 10, and the NCAA team were heartened to see that the vast majority of delegates answered the scope and dataset questions correctly. Controversially, very few gave the right answer for “Which football team does your NCAA Data Coordinator support?”, and Tyrone would like it noted that he is emphatically not a Spurs fan!
As always, we wanted to showcase those participants who have gone above and beyond to deliver high quality data to NCAA over the past year. For the 10th Anniversary we added a few special categories to celebrate individuals who have made significant contributions over the life of the audit.
Most Efficient Data Validation - Awarded to the hospital that has consistently completed and validated their data ahead of schedule each quarter.
WINNER: Warrington Hospital
Most Improved Data Validation – Awarded to the hospital that has shown the greatest improvement in the timeliness of data validation over the last year
WINNER: Cumberland Infirmary & West Cumberland Hospital
The winner of our “networking bingo” was a first-time Annual Meeting attendee; Jill Bennett from Royal Sussex County Hospital & Princess Royal Hospital, Haywards Heath
Special 10-year anniversary prizes:
Prizes were awarded to the individuals who have entered the most validated records in the last 10 years. To ensure a fair representation, we included a few subcategories.
Most Prolific Data Entry - Overall
WINNER: Peter Goodwin – Hull Royal Infirmary & Castle Hill Hospital
Most Prolific Data Entry – Single hospital
WINNER: Carl Davies - Queen Alexandra Hospital, Portsmouth
Most Prolific Data Entry – Small hospital (under 50,000 admissions per year)
WINNER: Carol White - Southport and Formby District General Hospital
10 years of NCAA
Finally, our 10-year achievement award went to the Resuscitation Officer who entered the first record into NCAA on 1 October 2009 and is still going strong.
WINNER: Ian Blakeley – Royal Manchester Infirmary
Ian could not join us in person but lit up the auditorium with a fantastic video acceptance speech. Congratulations and thank you to all of our winners.
Jerry Nolan closed the meeting with some reflections on the day before inviting the delegates to a drinks reception to celebrate NCAA’s first 10 years and toast to the next 10.
The NCAA team would like to extend our sincere thanks to all the delegates, speakers, chairs, exhibitors and ICNARC helpers who made the day possible. We look forward to seeing you all next year.