When the SAFER team at Wirral University Teaching Hospital NHS Foundation Trust (WUTH) asked Sister Yvonne Whiston and her team on Ward 22 to pilot “red and green days”, they thought that they were being asked to resurrect an old diet programme!

Once misconceptions were cleared up, Yvonne and her team embraced the process with dramatic results.

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Sister Yvonne Whiston (second from left) and the Multidisciplinary Team on Ward 22 Since rolling out the Productive Ward series over 5 years ago, our wards have undertaken daily MDT board rounds. More recently the wards adapted them to comply with the standards identified in the SAFER Patient Flow Bundle. Whilst the process was readily incorporated into the morning board rounds, conducting additional afternoon “huddles” consistently proved to be a challenge.

The launch day for Yvonne and her team was 25th May 2016, during a visit from Tim Gillatt and Coreen Eastes (ECIP Improvement Managers). They challenged the ward to complete as much of the day’s work within that day as possible.

Morning board round actions were reviewed at a re-invigorated afternoon “Huddle” where green days were allocated only when patient centred actions had been completed in their entirety.

The mood at the “huddle” was kept light as the team discussed each patient. An element of negotiating took place adding to the team’s learning experience. On day one it was agreed that 57% of patients experienced a green bed day. Whilst it was great to get a baseline, the team could now see the challenge ahead.

Moving forward one month, the team now regularly hit 90%.

Reflecting on the process, Yvonne states that she feels that she is more in control of her ward as the huddles provide her with the feedback and clarification required to assure her that all has been done for her patients that day.

Offering advice to others about to start on this journey Yvonne says:

• Keep it simple – tell people – it’s not rocket science.

• Keep the huddles to 10-15 mins – any longer and attendance drops!

• Keep the huddle light hearted – have fun negotiating for greens……but hold firm on principles.

• Embed the process “This is how we do things on our ward”. This will help, especially on Dr change over weeks.

Since starting red and green days on Ward 22, the team has increased both the volume of patients discharged each week and the volume of patients discharged before midday (our SAFER standard), hitting the SAFER standard 6 out of the last 7 weeks!

Dr Jayne Turner started her SAFER Patient Flow Bundle journey several months ago when she was working on our Diabetic/Endocrine ward as the bundle was introduced. Jayne then moved to Ward 22 as they stated their Red/Green day process. Jayne has been a strong advocate of the process declaring:

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“Red and green…………..be a team. Don’t forget all members of the MDT can help with setting and achieving daily goals”

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Whilst this is really encouraging news for the patients, it has also been really heart-warming to see the team on Ward 22 pick up and run with the process to the extent that “huddles” happen now even when Sister is off the ward.