What We Did… & Our Lessons Learned

Criteria Led Discharge Project

Bradford District Foundation Care Trust

Grainne Eloi HoS MHACS & Jo Gott PMO /Business Support & Improvement

Bradford District Population -

Deprivation

The Index of Multiple

Deprivation 2015

places Bradford as the

19th most deprived

district nationally

(where 1 is the most

deprived authority and

326 is the least

deprived).

Of the 31 districts in the

Yorkshire and Humber

region, Bradford is the

second most deprived

behind the City of Hull.

Criteria Led Discharge BDCT Driver

1.Innovative

2.Patient Safety

3.Care Closer to home

Project Charter Role Name Role Name

Project Sponsor Debra Gilderdale Staff engagement, Patient & Carer liaison, NHSI

Project Leader Grainne Eloi

Sarah Deacon Thabani Songo

Mohammed Sheraz Ullslam Chris Dixon

Neil Buckingham Tracy Loxam

Sarfaraz Shora Jo Gott

Julie Megaw Mark Trewin

Karl Bexley Bernard Hughes

Management of the admissions and discharges vary

depending on core and evening and weekend cover

which impacts patient flow . The discharge rates and

trends aren't fully understood for different days of the

week and how this impacts the average length of stay.

The average length of stay during the last 6 months are

194 days on Heather & 83 days Oakburn.

Improve average length of stay by introducing consistency of approach

and revised discharge criteria. During the 90 day pilots the ambition is

to decrease length of stay by 10% maximising the use and connection

/better use of community & IHTT resources. The pilot of 2 wards

Heather and Oakburn will undertake local detailed monitoring and track

operational changes and report lessons learned over the 90 day trial

prior to rolling out any success measures and learning across wider

inpatients in both acute and specialist wards.

Quality Issues Summary CustomersEmbedding a consistent approach to discharge will

aim to improve patient experience and flow of care into

the community.

Patient, carers, ward staff, IHTT Staff, CCG, community LA,

partnerships (Housing) consistency and compliance, finance and

better care/supporting ambition of care closer to home .

Project Team Stakeholders

Team Members

Problem Statement Goal Statement

How did we do it?

Pilot Wards - Heather

Average Length of stay was a 179 days at the start of the project. It went down to 77 day by the 8th of Oct. Which is a 57% reduction from the start of the project A total of 47 unique client went through CLD process

Pilot Ward- Oakburn

Average Length of stay was a 79 days at the start of the project. It went down to 29 day by the 8th of Oct. Which is a 63% reduction from the start of the project A total of 60 unique client went through CLD process

Deliverables

Deliverable

Act, Plan,

Study, Do Date initiated

Date planned

completion Who Complete/In Progress

Process Map our current agreed process

and review Study 07/08/2017 15/09/2017 Heather/Oakburn Sarah &Jo Complete

Mobilise Task Team DO 07/08/2017 15/08/2017 Sarah/Jo Complete

Discuss project and ambition with all

stakeholders including EMT and plan wider

communications Plan 15/08/2017 15/09/2017 Sarah Deacon CompleteReview admission/discharge tracker within

24 hours of admission with forecasted

discharge date DO 15/08/2017 30/08/2017 Neil /Sarfaraz Complete

Care Programme Approach plan booked and

completed within 3 working days Study 15/08/2017 02/10/2017 Ward Manager/named nurse In Progress

Baseline and track days of the week for dischargesStudy 07/08/2017 30/10/2017 Sheraz or James Complete

Baseline and track average length of stay Study 07/08/2017 30/10/2017 Sheraz or James Complete

Engagement sessions with Medics re

ambition Act 30/08/2017 Grainne /Sarah Complete

PIA Do 30/09/2017 Grainne/Jo Complete

live template to track discharge Act/Plan 10/09/2017 25/09/2017 Sheraz Complete

Develop step down reccomendation to

facilitate difficult to discharge patients

safely. Do 15/08/2017 30/09/2017 Grainne/Mark Not Started

Admission & discharge process tracking

and patterns/trends 24/7 Study 07/08/2017 15/08/2017 Sheraz or James Complete

Dishcarge Tracker Study and Do 15/08/2017 25/09/2017 Sheraz Complete

Complete deliverables 10

Total deliverable 12

Percentage complete 83%

1. Bespoke System

1. Bespoke System (Continued)

2. Live Information

2. Live Information (Continued)

3. Reduced Length of Stay (LOS)

Report Period ALOS Days

Start 01/09/2017 149

End 20/04/2018 68

% Difference 54.9%

85

52 35

53 50 49 45 28

0 20 40 60 80

100

Sep Oct Nov Dec Jan Feb Mar Apr

2017 2018

AV

E D

AY

S NHSE Return for LOS for Acute working age

149 122 121 116 104 94

81 68

0

50

100

150

200

Sep Oct Nov Dec Jan Feb Mar Apr

2017 2018

AV

E D

AY

S

Our LOS of Acute working age - SPC including active clients