Description: The objective was to improve service delivery, manage the length of stay of patients, ensure they were being discharged in a timely manner and improve the flow of patients through the service, thus freeing up bed capacity for emergency admissions and avoid out of area placements.
In February 2015, Bradford District NHS Care Foundation Trust (BDCFT) commissioned a productivity analysis of its Adult Mental Health Acute Inpatient Wards and began a 19-week transformation programme to improve the flow of patients through the service, decrease the average length of stay and reduce out of area placements
Historically the wards had over 100% occupancy of acute beds and, as a result, averaged around six people placed out of area per day, costing £1.8 million a year.
With productivity experts the teams worked to assess what was not working, what the barriers to care were, and how this affected the flow of patients through the wards. The productivity experts came into the wards to monitor daily work and procedures.
A key development was a ‘10 point’ discharge tracker. At the first clinical review after admission all patients are set a target discharge date. Variance against this date was then monitored within nursing handovers and tasks allocated to prevent any delay.
Equally the development of alternatives to hospital has been a key focus.
The Haven service is a new 365 day a year service developed in partnership with The Cellar Trust. It opens 10am – 6pm and has a specific aim to prevent A&E admissions. The emphasis on peer support from people with lived expertise, as well as support from the Intensive Home Treatment Team, who base the duty team within the Cellar Trust to support people who may need additional support. The service aims to support people in distress and work with them to develop their plans to stay well and improve coping strategies to manage distress in the future.
You can read in more detail about the acute inpatient ward outcomes - these outcomes have resulted in all people requiring acute care being treated locally and the lowest recorded bed occupancy (with leave) in the past five financial years. https://www.england.nhs.uk/mental-health/case-studies/mh-bradford/
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