Place increase in 4-hour ED performance ranking from 112 to 59 out of 122 hospitals
Reduction in ED patient delays
Increase in utilisation of the discharge lounge, improving flow out of the hospital
An acute hospital commissioned TN to support their transformation programme in response to decreasing performance and quality of care:
- The front of the pathway was not functioning as needed, for example, assessment areas had become ‘regular’ wards and medical clerking time was far too high
- There was ineffective grip on daily operations, leading to very long waiting times for patients to be admitted, patients being moved too often, and a high number of mixed sex breaches. This led to the trust being ranked 112 out of 122 nationally for 4-hour performance
- At the back of the pathway, the discharge rate was not high enough to accommodate demand and over a third of in-patients were medically fit and should have been discharged
- Developing one version of the truth: Conducted a system-wide diagnostic to develop an accurate and granular picture of the root causes of poor performance in Emergency Care, and identify the areas of focus for the programme
- Creating operational discipline: Improved operational discipline of site management to improve flow and quality of care including creating live site trackers, establishing clear escalation protocol, and instilling huddles utilising senior leader presence
- Improving the medical model: Reviewed the bed requirements for each specialty and area of the pathway, and adequacy of the current footprint to accommodate each specialty’s needs, and designed tailored solutions where gaps were identified
- Building leadership capability: Aligned leaders on the vision, and built tools and capabilities to support them to engage their teams and the wider Trust
