It is a little known fact that to be successful as an emergency physician in the UK it is vital to take a three month rotation in Archery. Archery is a key skill for us all dating back to Medieval times when we introduced the longbow into warfare. This devastating tool could cause panic in opposing forces, scattering them into many wide and ineffective directions. In short they were an effective tool to cause and disruption inthe opposition ranks whilst the noble English armies of old strode forward with their visions of the future. Soldiers trained using targets to hone their skills and to focus on the aim – meeting the target.
Of course these days we do not have real bows and arrows in the emergency department, but archery remains alive and well. In the modern NHS we still train our troops in archery, or at least in the principle aim of archery – to meet the target.
With our long history of target setting and target hitting it is therefore no suprise that we are world leaders in standards/targets/indicators….., whichever term you prefer in fact and it has to be said that a target culture in the NHS has been criticised widely, even being blamed for the exodus of trainees to Southern climes, but there is arguably more to it than that.
In last weeks episode we touched on new targets around trauma care in the UK and that raised many questions and opened a debate on twitter. This week we want to take those thoughts further and ask what we, as the archiest of arch archers across the entire NHS can do with these externally set targets.
What we forgot to say in the podcast is the absolute need to work alongside a short stay admissions unit under the ED umbrella. Without that you would really struggle to deliver safe and efficient care. We both work in units with short stay admission units that allow us to deliver safe diagnostic and therapeutic interventions to our patients.
The bottom line is that we didn’t choose the target, we didn’t agree with the targets, but we as they are there we need to ask what we can do with it to ensure that our patients, our staff and our systems get a better deal.
So, with some trepidation Iain and I ask whether all targets are a bad thing.
UPDATE: Since recording this podcast the College has published an update on emergency care. This is relevant and worth a read to all involved in setting, battling and achieving targets.
Mid Staffs enquiry http://www.midstaffspublicinquiry.com/