title: Breach avoidance facilitator--managing the A&E 4-hour target.
abstract: This paper aims to explore the concept of the breach avoidance facilitator (BAF) within the Accident & Emergency (A&E) department. This is a role that has been introduced utilising Senior Nursing staff on a supernumerary basis to predominantly provide a trouble-shooting role to manage the A&E 4-hour target. The paper will explore the initial practical difficulties that were encountered during the introduction of the role. The associated benefits of the role including monitoring of the 4-hour target, co-ordination of resources, increased communication with a variety of staff members, and the completion of a real time electronic hand-over form will be explored. The paper will also discuss how the role will evolve to provide support and clinical supervision for junior and ancillary staff.
authors.affiliation: Emergency Department, Basildon Hospital Foundation NHS Trust, Basildon, Essex, United Kingdom. Gerard.cronin@btuh.nhs.uk
authors.forename: J G
authors.initials: JG
authors.lastname: Cronin
authors.forename: J
authors.initials: J
authors.lastname: Wright
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration; D017598:Efficiency, Organizational; D016529:Emergency Nursing / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004739:England; D019983:Guideline Adherence; D018166:Health Care Reform / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D009718:Nurse Administrators / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009745:Nursing, Supervisory / Q000458:organization & administration*; D015279:Organizational Culture; D009936:Organizational Innovation; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D013222:State Medicine / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013997:Time Factors; D014850:Waiting Lists