Planning for Discharge
How can we free up beds for patients coming to hospital?
With winter approaching on the back of an ongoing pandemic, we were expecting a surge in acute admissions to our hospital. We were preparing to provide care to more patients than ever before, so needed to find ways to maximise our existing resources. One idea was to free up beds in our Orthopaedic wards by reducing the time from when a patient is cleared for discharge until when the patient leaves the ward.
Discharging a patient by midday is best practice, however even when we know which day a patient will be going home their discharge is often delayed until the afternoon. This delays one patient’s departure while another patient waits in the emergency department for a ward bed.
We worked with the Nurses, Physiotherapists and Occupational Therapists from Orthopaedic wards to identify what was causing these delays. By bringing these professions into one discussion we discovered that a key issue was communication between the teams.
If they were able to discuss a patient’s conditions for discharge earlier, they could coordinate their work and make sure that everything was sorted in time for a patient’s planned discharge time.
We established a process where the nursing team could flag to Physiotherapists and Occupational Therapists which patients were due for discharge the following day, so they could prioritise those patients’ needs. Along with a concerted effort to make prioritising discharges a cultural norm, this helped the wards to achieve a 12% increase in the proportion of patients discharged before noon and released beds.
October 2022
THANKS
Ward 75 and 77 staff
Orthopaedic Allied Health staff
AUTHOR
Luke Jones, Improvement Specialist
CONTRIBUTORS
Performance Improvement
Wards 75 and 77 Charge Nurses
Orthopaedic Allied Health leads