Publication - Advice and guidance
Patient care - daily dynamic discharge approach: guidance
Guidance on the daily dynamic discharge approach to improving the timeliness and quality of patient care by planning and synchronising the day's activities.
Implementation
Getting it right from the start - the implementation framework
In order to ensure that the DDD process becomes business as usual, it is necessary to consider all of the things that cause people to revert to 'safe' historical practices. The following table (page 23, 24) is a high level example of what needs to be considered during implementation.
| IT PREP | SET-UP | GO LIVE | SUSTAINABILITY |
|---|---|---|---|
| Ensure wardview, or the mechanism to view EDD is viewable/accessible | Identify area to hold the morning meeting | Identify a facilitator for the first few days, and a 'scribe' each day, coach and teach as necessary | Ensure 'golden hour' ward rounds become the appropriate next step - sick patients, then discharges, then all other patients |
| Ensure everyone knows how to log on and sort in ' EDD order' | Ensure the MDT know where and when the meeting will be | Write a rota for the first two weeks to support via the ' CCC' role to enforce escalation | Create escalation process with examples of delay and names/numbers to call (eradicate acceptance of delay) |
| Test the log in and 'change view' process | Publicise where/when/why/how often you hold these meetings | Benchmark ward data pre-start, number of discharges, pre-noon discharges, LOS, discharge lounge utilisation, delayed days, delayed patients etc | Revisit the numbers - devise an improving trajectory of discharge numbers and pre-noon discharges - use as part of PDP/development sessions |
| Ensure ward-view (or other system) is up to date with EDDs for all patients | Meet with management team ( GM, CSM, Lead Nurse), Consultants, Senior Charge Nurses, Ward Managers) to explain the process and agree the supporting structure | Link the improved understanding of discharge numbers into the huddle/bed managers/discharge lounge | Ensure the meetings happen at weekend, even if it's just the nurses who agree and prioritise discharge tasks, induct all new staff to this process on day 1 |
| IT PREP | SET-UP | GO LIVE | SUSTAINABILITY |
| Ensure wardview, or the mechanism to view EDD is viewable/accessible | Identify area to hold the morning meeting | Identify a facilitator for the first few days, and a 'scribe' each day, coach and teach as necessary | Ensure 'golden hour' ward rounds become the appropriate next step - sick patients, then discharges, then all other patients |
| Ensure everyone knows how to log on and sort in ' EDD order' | Ensure the MDT know where and when the meeting will be | Write a rota for the first two weeks to support via the ' CCC' role to enforce escalation | Create escalation process with examples of delay and names/numbers to call (eradicate acceptance of delay) |
| Test the log in and 'change view' process | Publicise where/when/why/how often you hold these meetings | Benchmark ward data pre-start, number of discharges, pre-noon discharges, LOS, discharge lounge utilisation, delayed days, delayed patients etc | Revisit the numbers - devise an improving trajectory of discharge numbers and pre-noon discharges - use as part of PDP/development sessions |
| Ensure ward-view (or other system) is up to date with EDDs for all patients | Meet with management team ( GM, CSM, Lead Nurse), Consultants, Senior Charge Nurses, Ward Managers) to explain the process and agree the supporting structure | Link the improved understanding of discharge numbers into the huddle/bed managers/discharge lounge | Ensure the meetings happen at weekend, even if it's just the nurses who agree and prioritise discharge tasks, induct all new staff to this process on day 1 |
Contact
Email: Unscheduled Care Team
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