We’ve developed our safer, faster, better (SFB) programme to make sure our patients are treated safely when they’re with us – and to get them back to the comfort of their own homes as quickly as possible.
At any one time, we have more than a ward full of patients who do not need to be in hospital. We’re using a number of initiatives to help ensure our patients get home as soon as they are medically well enough. These include:
Daily board rounds
We hold daily board rounds to assess the progress of every patient and address any delays to their treatment or discharge. A multi-disciplinary team of doctors, nurses, therapists, pharmacists and flow co-ordinators come together during the board rounds to share knowledge and decision-making for each patient.
Red and green days
We use a red and green day system to help us reduce delays to discharge. A red day highlights a wasted day in a patient’s journey, for example when a patient is waiting for an investigation. A green day is when a patient receives care or treatment that supports their pathway of care bringing them a step closer to their discharge.
All patients start the day as red. As a team, we identify what needs to happen to turn it green and we then put a plan in place to make this happen. If it has happened by the time we review at the afternoon huddle, the day is recorded as green. If it doesn’t, the day stays red.
We have implemented the SAFER bundle to improve patient flow and prevent any unnecessary waiting for patients.
All patients are seen every day by the medical team and decisions are quickly made with regard to investigations, treatment and plans for discharge or transfer to the most appropriate place.
Senior review – patients will have a senior review before midday
All patients will have an expected date of discharge
Flow of patients will begin at the earliest opportunity from our short stay units
Early in the day discharge – our aim is to have 33% of patients discharged before midday when they are medically fit to leave the hospital
Review – a systematic multi-disciplinary review of patients who have an expected length of stay under seven days.
As soon as they are ready we take patients to our discharge lounges. Our patients are then able to wait for their medication to take away or transport in comfort while enjoying refreshments.
Helping our patients to get up, dressed and moving is a key part of our SFB programme.
The #endPJparalysis campaign, which highlights the impact of patients being left in pyjamas or hospital gowns for any longer than necessary, started on Twitter and has spread across the UK.
While patients of all ages can benefit from being more active, it’s particularly important for older people. Recent studies have shown that 10 days in bed can lead to 10 years of muscle ageing in people over 80 years old.
In November 2017, staff at Barnet Hospital took part in our first ‘perfect week’ to help improve the experience of our patients and staff.
Teams including doctors, nurses, allied health professionals and managers focussed on the journey of every patient to understand what was needed to discharge them quickly and safely.
‘Perfect week’ is a tried and tested approach across the NHS to help ‘reset’ a hospital by creating internal capacity and relieving pressure. It was supported by the hospital’s healthcare partners – including clinical commissioning groups and local authorities – who helped by identifying capacity in the community for patients who do not need to be in hospital.
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