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Optimising hospital flow, including discharge to ensure front end emergency care capacity.

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’.

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Optimising hospital flow, including discharge to ensure front end emergency care capacity.

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  1. Seven Day Services Improvement ProgrammeBirmingham, Sandwell and Solihull CollaborativeProfessor Matthew CookeDeputy Medical Director (Strategy & transformation)Heart of England NHS FT‘7 day services is only part of a whole system transformation’

  2. Optimising hospital flow, including discharge to ensure front end emergency care capacity. • Flow is a whole system issue. • Where are the bottle necks?

  3. 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

  4. 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.

  5. 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

  6. Monitoring systems, including Jonah • Feedback mechanisms

  7. Gap analysis Therapies Nursing Senior Medical Junior Medical Clinical support Non-clinical support

  8. Discharge hub 7/7 • Access to community facilities 7/7

  9. Mortality rates – same by day of week

  10. Discharge rates still reduced at weekend

  11. LOS of stay varies but……

  12. Reducing variation • By day • By team • By individual • It is not a seven day services programme

  13. Questions ?

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