Walsall Manor Hospital have established an effective discharge lounge which has greatly supported in-hospital flow, and safe and timely discharge for patients. A permanent physical space was allocated to the discharge lounge and this is now staffed by a permanent team with strong leadership.
Crucially this physical space has been designed to be homely and comfortable, to act as that bridge to home. The dedicated team has focused on improving processes, such as identifying patients on wards who are close to being clinically ready for discharge and then working with ward staff to ensure the discharge process is enacted in a safe and timely manner. In part, this has been enabled by the same leadership oversight of the discharge lounge and patient flow. The discharge lounge has also had its opening hours extended, now running 7am-10pm on weekdays and 12 hours shifts on weekends. The Trust’s commitment to the Discharge Lounge service is evidenced by the fact that the unit is fully protected, and is never used as inpatient escalation bed capacity.
In 2019, a permanent physical space was allocated to the discharge lounge, staffed by a dedicated multidisciplinary team. The space has been designed to be homely and comfortable, to act as that bridge to home. The trust’s commitment to the discharge lounge service means that the unit is fully protected and is never used as inpatient escalation bed capacity.
Throughout 2021 the team focused on improving pathways by identifying patients on wards who are close to being clinically ready for discharge and then working with ward staff to ensure the process is safe and timely. In 2022 the discharge lounge also had its opening hours extended, now running 7am to 10pm on weekdays and 12-hour shifts at weekends.
Being discharged via the discharge lounge is now seen as the default pathway (unless there is a clinical reason not to), which has taken the proportion of ward discharges that leave the ward before 9am from about 6% to over 9%, and 23% of ward discharges now leave the ward before midday. This has benefits for patients across the whole pathway by improving overall flow.
Patient experience has been improved with services provided such as food parcels for patients being discharged and organising social support follow-up visits in patients’ own homes post-discharge. This also helps to prevent readmission and successful return home.
Benefits so far:
- Being discharged via the discharge lounge is now seen as the default pathway (unless there is a clinical reason not to). This has more than doubled the number of patients discharged through the lounge over the last 2 years, and has taken the proportion of ward discharges that leave the ward before 9am from circa 6% to over 9% with statistically significant improvement evidenced. 23% of ward discharges leave the ward before midday now too.
- The discharge lounge has benefits for patients across the whole UEC pathway by releasing inpatient hospital beds earlier in the day. This then supports transfers from assessment units (such as acute medical units and frailty units) into inpatient wards, consequently releasing space in assessment units for patients to flow from the emergency department, therefore reducing handover delays from ambulances into ED, and ultimately ensuring more timely response to 999 calls in the community.
- The extended opening hours of the lounge have benefitted both admitted and non-admitted patient flow. The earlier mornings allow for earlier release of inpatient beds. The later evenings help to release cubicle capacity in the ED and SDEC units (where demand is often highest in evening) as patients who are deemed clinically ready to leave but still awaiting collection or final treatment can be cared for in the discharge lounge.
Next steps:
- Continue to increase integration with base wards and assessment units to reinforce the purpose of discharge lounge.
- Continue integration with other community-based agencies, voluntary sector partners, and social care to help prevent re-admission.
Catch up with the team through a recent podcast here or watch a learning event that the discharge lounge team put on here
Contact Nicky Dixon - [email protected]