There are no magical solutions to improve urgent and emergency patient flow. It’s a complex system and therefore doesn’t work particularly well when complicated rules are used. One approach that has proved to be popular with a number of health and care systems is red and green days. It’s a great example of using simple rules to help reduce delays for patients by making non value adding days (from a patients perspective) visible and a daily topic of conversation for clinical and managerial staff. It works particularly well when it is used across inpatient wards where patient ‘s often experience significant periods of time waiting for things to happen.
For older patients in particular, unnecessary waiting in an acute or community hospital carries significant risks. For patients that are ready for discharge or transfer to a non acute setting, hospitals are not the best place.
“10 days in hospital (acute or community) leads to the equivalent of 10 years ageing in the muscles of people over 80”
There is no definitive way to implement red and green days, but a popular approach is to initially test it out on a couple of wards using an approach that could include:
All multi disciplinary team (MDT) members asking on every board or ward round if today is going to be a red or a green day
- If it’s going to be a red day the MDT make every effort to resolve the problem in real time
- If the MDT cannot resolve the problem i.e. prevent the patient from having a red day, there are clear and simple escalation processes in place that involve all levels of health, social care and other staff groups (including the voluntary sector) again responding to delays in real time
- Recording red and green days in a visual manner i.e. so its clear for all to see the number of red and green days on patient status at a glance boards (ward boards) and IT systems
- After testing it out on a couple of wards, devise a plan to implement it across a hospital site (with system wide health and social care support) so it starts to be part ‘of the way we do things around here’
If you are struggling with patient flow, give red and green days a go!