Initial situation

The medical division was experiencing problems managing patient flow and meeting patient demand. In particular, bed utilisation was 100% - 10% above the trust’s target and 15% above the nationally recommended figure.

Project objectives

The aim of the project was to find ways to improve the management of patient flow through the division. The project focused on the acute care of the elderly wards due to:

• Length of stay rates were longer than benchmarked peers.
• The high percentage of elderly people admitted as emergencies.
• Concerns about the effectiveness of the team working in this area.

What we found

• The team were not planning for patient discharge effectively.
• Nurses, therapists and social workers were not coordinating their work effectively.
• Patient progress against recovery milestones were not being monitored.
• No information or feedback systems existed to inform the medical division about the length of stay and discharge rates which they needed to achieve in order to meet patient demand.

Solution proposed

• A number of visual management tools were introduced to help the team.
• Focus on their discharge planning activities to start from admission.
• Ensure patient progress against key recovery milestones via monitoring.
• Improve effectiveness of multi-disciplinary team working and ensure that medical division team were focused on common goals.