Breach avoidance facilitator--managing the A&E 4-hour target

Accid Emerg Nurs. 2006 Jan;14(1):43-8. doi: 10.1016/j.aaen.2005.11.005.


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.

Publication types

  • Evaluation Study

MeSH terms

  • Attitude of Health Personnel
  • Communication
  • Continuity of Patient Care / organization & administration
  • Efficiency, Organizational
  • Emergency Nursing / organization & administration*
  • Emergency Service, Hospital / organization & administration*
  • England
  • Guideline Adherence
  • Health Care Reform / organization & administration
  • Humans
  • Interprofessional Relations
  • Nurse Administrators / organization & administration*
  • Nurse Administrators / psychology
  • Nurse's Role* / psychology
  • Nursing Evaluation Research
  • Nursing Methodology Research
  • Nursing, Supervisory / organization & administration*
  • Organizational Culture
  • Organizational Innovation
  • Practice Guidelines as Topic
  • Quality Assurance, Health Care / organization & administration
  • State Medicine / organization & administration
  • Surveys and Questionnaires
  • Time Factors
  • Waiting Lists*