optimising hospital flow, including discharge to ensure front end emergency care capacity
DESCRIPTION
Seven Day Services Improvement Programme Birmingham, Sandwell and Solihull Collaborative Professor Matthew Cooke Deputy Medical D irector (Strategy & transformation) Heart of E ngland NHS FT ‘7 day services is only part of a whole system transformation’. - PowerPoint PPT PresentationTRANSCRIPT
Seven Day Services Improvement Programme
Birmingham, Sandwell and Solihull Collaborative
Professor Matthew CookeDeputy Medical Director (Strategy & transformation)
Heart of England NHS FT
‘7 day services is only part of a whole system transformation’
Improving health outcomes across England by providing improvement and change expertise
• Optimising hospital flow, including discharge to ensure front
end emergency care capacity.
• Flow is a whole system issue.
• Where are the bottle necks?
Improving health outcomes across England by providing improvement and change expertise
How we are addressing it:
Perfect Week, including with community SAFER care bundle Monitoring systems, including Jonah Feedback mechanisms Gap analysis Discharge hub 7/7 Access to community facilities 7/7
Improving health outcomes across England by providing improvement and change expertise
Perfect Week, including with community
• The perfect week methodology is a way of resetting a broken system relying on a mixture of social movement theory, multiple rapid improvement methodology and strong leadership and support mechanisms.
• It has been developed to help solve poor flow in hospitals resulting in overcrowding in emergency departments. One week of intense improvement activity can improve flow across the whole hospital resulting in safer, higher quality care and it can then be sustained.
Improving health outcomes across England by providing improvement and change expertise
S - Senior Review, all patients have a Daily Consultant Review , sick and discharge patients seen before 10am
A - All patients a Planned Discharge Date
F - Flow , every ward should have a min. of 1 bed available from 9am to enable emergency assessment and theatre services to flow safely.
E – Early discharge, 50% of our patients will be discharged from base inpatient wards before midday.
R – Review, a weekly systematic review of patients with extended lengths of stay ( > 14 days
Improving health outcomes across England by providing improvement and change expertise
• Monitoring systems, including Jonah• Feedback mechanisms
Improving health outcomes across England by providing improvement and change expertise
Gap analysis
Therapies
Nursing
Senior Medical
Junior Medical
Clinical support
Non-clinical support
Improving health outcomes across England by providing improvement and change expertise
• Discharge hub 7/7• Access to community facilities 7/7
Improving health outcomes across England by providing improvement and change expertise
Mortality rates – same by day of week
Improving health outcomes across England by providing improvement and change expertise
Discharge rates still reduced at weekend
Mon Tue Wed Thur Fri Sat SunDay of Discharge
0
2000
4000
6000
8000
10000
12000
14000
Discharges by day of discharge
242526272829303132333435363738394041424344454647484950515253 1 2 3 4 5 6 7 8 9 1011121314151617181920210%
5%
10%
15%
20%
25% % discharged at Weekend - Monday 4th June to Sunday 27th May (Nonelec Only)
Improving health outcomes across England by providing improvement and change expertise
LOS of stay varies but……
Mon Tue Wed Thur Fri Sat SunDay of Admission
1.9
2.0
2.1
2.2
2.3
2.4
2.5
Average LOS by day of admission
Reducing variation• By day• By team• By individual
It is not a seven day services programme
Improving health outcomes across England by providing improvement and change expertise
Improving health outcomes across England by providing improvement and change expertise
Questions ?