Yvonne Blücher (manager director) from Southend University Hospital NHS Foundation Trust shares her blog marking the start of the trusts week of action to ensure patients leave hospital as soon as they are fit to do so.
This week the Emergency Care Intensive Support Team (ECIST) have been working with Southend University Hospital NHS Foundation Trust delivering a week of action to implement, and begin to embed, improvements that will ensure patients leave the hospital once they are fit and well to do so. To mark the launch of the week Yvonne Blücher (managing director) wrote a blog, and ECIST are grateful to Yvonne for allowing us to share that blog with our readership.
Today [February 11th 2019] marks the start of a week of action here at Southend, showing that we value our patients’ time.
Staff across the Trust but particularly with medical wards will be focussing closely on two key objectives that will help ensure our patients leave hospital as soon as they are fit to do so:
- To reduce the number of patients staying in our hospital for 14 days or more
- To ensure that every patient has a comprehensive Clinical Criteria for Discharge (CCD) documented in their notes, and to embed that practice across the Trust
“What are we waiting for” is a question asked by patients, relatives, ward staff and managers alike, and that’s a question that we all need to be able to answer. It’s a sobering thought that one in three of our acute medical patients are in the last year of their life, so we should be doing everything we can to get them out of an acute medical setting and back to the comfort of families and familiar surroundings for their recovery.
During the week ward liaison officers (WLOs) will be visiting the wards to look through patients’ notes and identify whether a well written CCD is documented. This simple tool identifies why a patient is in hospital and when they can safely be medically discharged. Having specific and measurable criteria in place that can be understood by the whole team – and the patient and relatives – creates realistic expectations and safely delegates responsibility for making patients medically fit for discharge to more junior members of the medical team and senior nurses.
So the ‘challenge’ during the next week will be to ask the following questions:
- What are the criteria for discharge and where is it documented?
- How could it be improved?
- Could an opinion or test be arranged after discharge?
- Does the patient or relative know what they’re waiting for?
- Would a nurse be happy and confident to discharge a patient based on the CCD?
And we hope that by answering these questions honestly and making positive changes in response to those answers we can improve our patients’ experiences and flow through the hospital.
Going hand-in-hand with next week’s theme of ‘valuing our patients’ time’ is using TeleTracking to improve patient safety and experience. The system has been live for three months now, so we’re starting to be able to assess how well we’re using it. There are definitely areas where we need to improve our compliance, so over the next couple of weeks we’re going to focus on
- Badge drop box compliance
- Recording of pending (next 24 hours)discharge
- Recording of confirmed (today) discharge
Improving compliance in these three areas can make such a difference. For example, around 190 hours of nursing time per week could be put back into direct nursing care by dropping badges into boxes when a patient is discharged – that’s more than 5 full time nurses. Dropping a badge in a box automatically kicks off the process of a bed being cleaned and ready for the next patient, improving flow and reducing delays for our sickest patients – those waiting to be admitted to a bed.
As always we’re encouraging a bit of healthy competition and offering a few prizes for the areas achieving and sustaining the best performance.
However the real winners in the end will be our patients who will have a better experience while they’re in our care.
Please get involved this week and thank you for your hard work.
Yvonne Blücher
Managing Director
Emergency Care Improvement Support Team 