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
The measurement framework
In all tests of change, measuring improvements is not just important but necessary. This may be done as part of a 'test of change' or PDSA cycle in the first instance. Defining an improvement trajectory based on this data is key to sustaining the initial improvements and further improving. Delivering incremental improvement across several wards should equal improved flow across the site.
| MEASURE AT WARD LEVEL | MEASURE AT SITE LEVEL |
|---|---|
| Reduction in average length of stay | Reduction in length of stay overall |
| Increase in number of discharges | Improvement in performance against emergency access target |
| Reduction in delay (number of patients and number of days) | Reduction in occupied bed days (reduction in % occupancy), improved access - both emergency and elective |
| Increase in number of discharges pre-noon and less discharges late in the evening | Improved flow - peak of demand better aligned with peak of capacity, less ED crowding at peak times |
| Improvement in patient experience (less delays in access AND in discharge) | Improved staff morale (less tension about beds, fewer 'in extremis' days) |
| Reduction in Datix incident/risk reporting - better planning, fewer clinical incidents and better relationships with facilities/pharmacy/transport as last minute requests decrease | Easier identification of ACTUAL gaps in rotas (less trying to build a rota around bad practice related to late in the day discharge) |
Contact
Email: Unscheduled Care Team
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