Healthcare Technology reduces Bed Blocking and Delayed Discharges Case Study
Healthcare Technology reduces Bed Blocking and Delayed Discharges Case Study

Hull & East Yorkshire NHS Hospitals Trust

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Hull and East Yorkshire NHS Hospitals Trust has completely revolutionised the way it manages patient flow, improving patient safety and experience, as well as boosting staff morale, since deploying new technology in 2011.

Through a cycle of continuous improvement and innovation, they have extended the patient flow solution to encompass an ever widening footprint that now includes infection control, pharmacy, transport and even the Chaplain's service.

Like all trusts, Hull were facing the problem of increased demand and stretched community based services to support appropriate discharge. The resultant bed blocking and extended lengths of stay drove them to seek out an alternative solution to these problems. Throught the patient flow software provider's customer network and user forum, they were able to evaluate discahrge related innovations designed and deployed in 2013 at Chesterfield Royal NHS Foundation Trust. Hill liked what they saw and at the end of 2014, they deployed similar discharge planning function tailored to their own processes and community partner needs.
Both Hull and Chesterfield systems are based on engaging in proactive planning for discharge as soon as a patient is admitted. Central to this is the setting of an expected date of discharge, together with the selection of an appropriate discharge pathway for each patient. This pathway determines what activities need to be completed before the patient can be discharged. The multi-disciplinary teams (MDTs) delivering the agreed plan of discharge use the patient flow system to monitor and update the status of the discharge activities to ensure that everyone has a clear picture of the progress being made towards the anticipated discharge. The MDT's include social workers, intermediate care and rehabilitation providers in the community, pharmacy, therapists, hospital discharge co-ordinators and the ward medical teams.

By providing a clear, up-to-date view of all outstanding discharge tasks, staff work lists are maintained to ensure that patient intervention is correctly prioritised and that any issues which might result in a delayed discharge are addressed early in a patient's stay. When discharges are delayed, hospital wide views are used to analyse and manage the reasons the delay.

Hull have eliminated repetitive paper based data entry, by providing a single electronic point of capture for patient information, thus reducing the administration involved in the discharge process. Developing the patient flow system to improve discharge has provided staff with a focus for clearly understanding and improving current processes. Communication and collaboration within the MDT's has also improved since deploying the changes.

In addition to contributing to a shorter length of stay, patients and their relatives also benefit from a clearer picture of what progress is being made towards the expected date of departure.
Benefits of using Cayder PFM

  • Actual transfer times - reduced from 22 to 5 minutes (patients can be transferred electronically across wards with information flowing seamlessly between teams)
  • Electronic transfers - at least an hour of clinical time is saved on each and every ward in the organisation every time a patient is transferred. Key patient safety information being available instantly to the receiving ward team
  • Clinical handovers - 15 minute reduction per patient
  • Discharge times - are halved and completed in real-time at the touch of a button
  • Non-ward efficiencies – the creation of virtual wards mean patients are discharged quicker (i.e. medicine reconciliation can be done quickly as the pharmacy can prioritise it's workload by knowing which patients are likely to be discharged)
  • Response rates – the diabetic virtual ward allows the diabetic in-reach team to manage care and referrals faster than previous manual processes, improving patient care and reducing costs associated with unnecessary tests.
  • Patient safety and overall patient experience - staff have more time to spend on clinical actions, direct care time has increased and information being readily to hand and not buried in notes mean patients' feel the difference
  • Transparency of movement – patients are more often in the right bed at the right time