Bendigo Health has introduced a number of initiatives to try and free up hospital beds and reduce Emergency Department wait times.
The Timely Excellent Care Collaborative (TECC) consists of three workgroups (Hospital Operations, Inpatient and Emergency Department) introducing strategies to improve patient flow throughout the hospital.
Bendigo Health aims to ensure every patient receives the right care in the right place at the right time and the TECC aim is to reduce the average length of stay in the Emergency Department for admitted patients by 20% and 15% for non-admitted ED patients by June 30 2024.
Achievements
The first focus was to increase the number of patients discharged before 10AM.
Freeing up beds earlier in the day assists with planning and management of flow, allowing those patients requiring a bed to receive the care they need in the correct ward sooner. For patients going home, a smooth transition from hospital to home earlier in the day improves the overall patient experience.
Inpatient Stream – Ward 6C
In the first five weeks of the trial, ward 6C have increased the number of patients discharged prior to 10am by 19% through their “Golden Ticket” PDSA cycle.
The aim of the Golden Ticket was to ensure that all discharge tasks are complete and the patient is dressed and sitting out of bed ready for medical review at 9AM. At 12PM the medical team identify patients ready for discharge the following day. This assists the medical, nursing and allied health teams to ensure that all discharge tasks such as consulting the patient, ensuring transport is available, ordering and dispensing discharge medications are completed the afternoon prior to discharge.
Further enhancements are being implement, like a discharge checklist for all identified early discharge patients being on display in the handover room
ED Workgroup – Short Stay Observation Unit
Discharges from Short Stay Observation Unit before 10am have increased by 7%. The aim of the “Priority Discharge” PDSA was to prioritise patients ready for early discharge to be reviewed by the medical team in their rounds first to ensure beds are available earlier for patients in ED awaiting transfer.