Being in hospital limits the choices patients have regarding how they spend their days, every day not in hospital is a day we give patients their lives back. The aim of our ‘red to green’ initiative is to identify and remove the blocks and barriers which stand in the way of providing the best patient care.
Underpinned by 'professional standards' , which clarify expected time periods for interventions to be performed, with automated tracking mechanisms to analyse where these are not able to be achieved, resulting in delay (red days). Analysis of red days gives us our focus areas for continual quality improvement. A green day is a day when the patient has received an intervention in accordance with their care plan to support their journey through to discharge in accordance with an agreed professional standard. A Red day is when the patient ‘does not’ receive an intervention which was requested or planned, or where an agreed professional standard has not been achieved.
Our 'Red to Green' initiative is performed in two ways:
1. Daily identification of ‘red days’ on ward areas, outpatient areas and theatres, which are discussed in daily meetings, with clear actions agreed for staff to unblock
2. Whole-system 'Red to Green' intensive support weeks
During a planned Intensive support week, non-urgent meetings are cancelled and teams from across the trust and the wider system, are jointly focussed on sharing and unblocking issues in real-time. We have run 3 of these weeks to date, which have delivered remarkable results in reducing length of stay, closing ward escalation areas, improving processes and communication and sharing learning across the entire system.
We have also run specific ‘theatres’ and ‘ED’ Red to Green weeks, where we have focussed on setting and delivering professional standards in these areas, with the overall aim of achieving continual improvement. A few examples of ‘red to green’ in action:
• Diagnostic Imaging put on additional capacity to enable patients to go home earlier
• The Cardiology team put on an extra list in the Heart Centre at the weekend, to reduce the backlog of patients waiting for angiograms, PCIs and pacemakers.
• Teams of trained staff volunteers made a real difference to patient care, by making beds, portering, helping at meal times and courier work for pharmacy, supporting front line clinical areas.
• “The only thing stopping one elderly patient from going home was the fact her husband – her main carer – was also in hospital. The Red to Green team arranged a temporary placement in a residential home for the lady until her husband was ready to go home and look after her again”.
• A man who needed oxygen and was living in top floor accommodation with shared facilities on different level was rehoused through intervention by Housing colleagues
• Our ward length of stay is currently the lowest ever achieved and our system-wide engagement and support to unblock barriers is pivotal to our ongoing success at Ipswich.
