Patient Flow

In a nutshell: Mapping a patient's care journey shows that the majority of time is spent waiting. Through this programme we are supporting NHS organisations to design processes to provide what patients need when they need it. This results in improved patient flow, a calmer care environment, a reduced length of stay, and greater patient satisfaction.

The Challenge

The NHS is in crisis and is struggling to cope with the rising number of hospital admissions. In December 2015, more than 5 000 patients in England experienced delays in being discharged from hospital. Delays in transfer of care resulted in a loss of more than 150 000 bed days in the same month*. Hospitals are under severe pressure with this increase in demand and we need to change how hospitals work in order to solve this crisis. (*The King's Fund Quarterly Monitoring Report)

It is widely recognised that achieving good patient flow in an acute hospitals is a daily struggle, resulting in A&E breeches and patients waiting unnecessarily. Similar patient flow problems occur in all settings including community, mental health, and primary care.

What are we doing about it? 

The Improvement Academy has been working with acute trusts across Yorkshire and Humber to find new and novel ways to improve patient flow. The underlying principle is to ensure that patients receive their treatment at the right time, in the right place and in full.

The Improvement Academy has been working with frontline teams to develop and test our intervention Achieving Reliable Care (ARC)  which works at ward team and individual patient level to improve the reliability of patient care.

Our case study illustrates a reduction in average length of stay on this elderly care ward using the TAPPs intervention from 11.7 days to 7.2 days.

 Our Future Plans

Achieving Reliable Care (ARC)
We will continue to work with Trusts to understand how ARC can be spread and sustained at scale across whole hospitals so we can begin to see results at hospital level. We will support organisations who want to use and adapt ARC in other settings.

Understanding the barriers to good patient flow

We recognise that the presence of a tool like ARC does not automatically guarantee that it will be used, or that patient flow is high on the list of clinical and ward staff's priorities. Therefore, we wish to understand the barriers and facilitators to achieving patient flow, using the Achieving Behaviour Change for Patient Safety Toolkit.

Level discharges

We have identified a number of Trusts who are interested in looking at the concept of levelling discharges throughout the day in order to help in-day management of flow at hospital level and we will be working with them to develop a further tool which can be used by our member organisations across Yorkshire and the Humber.

Quality Improvement Training

Have you seen our Quality Improvement Training? Read all about our Bronze, Silver and Gold level training for staff at all levels in Yorkshire and Humber in our Training and Events section.