Major progress in ensuring ‘Right bed, right patient, first time’ at St George's Healthcare
Bed capacity issues emerged as a recurrent theme at LiA Staff Conversations held at St George's Healthcare NHS Trust in 2013.
As a result, some improvements were made to increase capacity. However, during the winter period of 2013/2014 the Trust experienced high occupancy rates, crowding in assessment areas, and patients in the wrong beds where they were not best placed to have their health issues addressed appropriately. This was having a detrimental effect on patient care and safety.
It was clear that the earlier solutions put in place were not working – something had to change. So in April this year the LiA approach was used to implement ‘The Perfect Week’ at the Trust. The aim of the week was to dramatically improve the patient experience, safety and staff morale by ensuring that all admissions would be ‘right bed, right patient, first time’. Multidisciplinary teams in wards worked together to come up with ideas and solutions to the problems they were facing.
A number of actions were implemented during the week, these included:
• Ward staff having fast access to a dedicated help service for using the Agile Patient administration system
• Operational leaders being visible and available to troubleshoot
• Scrutiny from liaison officers which provided focus on daily issues affecting the wards.
Giving staff ‘permission to act’ during the week resulted in some really positive outcomes:
• 92% of issues raised were resolved during the week
• Capacity was increased and escalation wards were clear for most of the week
• Patients were in the right place and outliers significantly reduced.
Lessons have been learned and changes sustained. Further changes agreed by the teams include:
• Implementing a programme of actions to resolve issues raised during the week
• Re-running 'the perfect week' every quarter
• Running a special issue 'Perfect Week' to address notes tracking
• Setting up a permanent discharge lounge
• Challenging the number of meetings and emails staff have to deal with to create more time to focus on delivering patient care.
This important work means that patients are benefitting increasingly from improved care in a timely manner, in the right environment, from staff who have more time to care for them. This will result in them spending less time in hospital and being discharged in a planned, timely manner.