Patients known as ‘High Impact Users’ (HIUs) attend our Emergency Department up to 80 times per year. Mental health problems, drug/alcohol use and homelessness account for almost all of the presentations, and the group has an average age of death in the thirties. The SHarED (Supporting High impact users to Emergency Departments) Project seeks to change this.

The SHarED Quality Improvement toolkit was originally created in March 2018 by the West of England AHSN in collaboration with the HIU team at University Hospitals Bristol NHS Foundation Trust (UH Bristol). This guide has been developed to support the implementation of the SHarED Project in local Emergency Departments.

The project is about supporting an innovative, system-wide approach that improves service user experience, supports staff, and reduces Emergency Departments attendances and hospital admissions.

The toolkit is based on the experience of the UH Bristol team in implementing a High Impact User Team in to the Emergency Department. The majority of resources available in this toolkit are made for immediate use; however they may require some adaptation to suit the local implementing site and have been designed accordingly.

The complete SHarED Implementation Guide

The SHarED Implementation Guide is designed to help local Emergency Department teams support high impact users. The complete guide is best for gaining an understanding of the project rather than using as working documents. For working documents see below.

View the guide



Working documents from the SHarED Implementation Guide

Data collection

HIU co-ordinator resources

HIU Multidisciplinary Team (MDT) documents

Patient Surveys

Patient Information

Project Communications

Project Management

SHarED Project Quality Improvement

Emergency Department

SHarED: Supporting high impact users to Emergency Departments

This project aims to improve outcomes for the most frequent users of Emergency Departments.

Read more