6EA Improvement Programme Update

Helen Maitland

Unscheduled Care Director,

Scottish Government

6 Essential Actions 1. Clinically Focussed and Empowered Hospital

Management

2. Capacity and Patient Flow Realignment Process

3. Patient rather than Bed Management

4. Medical and Surgical Processes aligned for Optimal Care

5. Targeted 7 Day Services (whole system)

6. Patient Cared for in their Own Home

2

6 Essential Actions to Improving Unscheduled Care Performance

Safe, Person

Centred,

Effective Care

Delivered to

Every Patient,

Every Time

Without

Unnecessary

Waits, Delays

and

Duplication

Capacity and Patient

Flow Realignment

Medical and Surgical

Processes Aligned for

Optimal Care

7 Day Services

Ensuring Patients are

Cared for in their Own

Homes

Clinically Focused and

Empowered

Management

Patient and

Staff

Experience

Patient rather than Bed

Management -

Operational

Performance

4

To achieve: Improve: By managing: Do these well: Triumvirate Management

Clinical Leadership

Escalation

Safety, Flow Huddles

Basic Building Blocks

Bed Planning Toolkit

Workforce Capacity Toolkit

Performance Toolkit

Patient tracking through system

Admission/ discharge prediction

Balance capacity & demand

Daily Dynamic Discharge

Triage to appropriate assessment

Flow through ED

Access to Senior Decision Maker

Access to Assessment/Diagnostics

Smooth variation in services

Surgical Emergency & Elective Services

Access to Diagnostics /Intervention

GP/OOH Support

Redirection / Know Who To Turn To

Shift Emergency to Urgent

Short stay assessment / Avoid admission

Discharge when fit & ready

1. Clinically Focused and Empowered Management

• Triumvirate Management

• Clinical Leadership

• Escalation

• Safety, Flow Huddles

– Morning - waking the hospital up

– Afternoon – prediction for next day

2. Capacity and Patient Flow Realignment

resources applied at right place, right time

combined elective & emergency capacity plan

• Basic Building Blocks

• Bed Planning Toolkit

• Workforce Capacity Toolkit

• Performance Toolkit

3. Patient Rather than Bed Management

coordinated planning & implementation of appropriate discharge with no delays

• Daily Dynamic Discharge

• Early in Day Discharge

• Use of Discharge Lounge

• Electronic Whiteboards

• Afternoon huddles - focus on prediction

4. Medical and Surgical Processes

improve patient flow through the unscheduled care pathway

• ‘Pull’ patients from the ED – manage exit block

• Ward based target to achieve admission & discharge balance

• Assessment in most appropriate place

• Access to specialist clinical interventions

• Acute Quality Standards

5. Seven Day Services

appropriately targeted to reduce variation in weekend and out of hours working

• Diagnostics

• Support services

• Pharmacy

• Sunday Demand

6. Patients Cared for in Their Own Homes

Active and Independent Living

Living Well in Communities

Reduce LoS

Admitted

Avoid Admission

Discharge when ready

Health & Social Care Partnerships

Appropriate Assessment

Avoid attendance

Manage well at home

EA6 - Priorities

• Community COPD Management

• Time of GP contact to time of arrival via SAS

• Alternatives to admission survey

• GP based Virtual Ward

• Reducing attendances

NHS App

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Thank you