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Publication - Guidance

The Daily Dynamic Discharge Approach Guidance Document

Published: 20 Jun 2016
ISBN:
9781786522986

The Daily Dynamic Discharge Approach - Improving the timeliness and quality of patient care by planning and synchronising the day’s activities. This document aims to help readers and potential implementers understand some of the ‘man-made’ causes of delay

30 page PDF

1.2MB

30 page PDF

1.2MB

Contents
The Daily Dynamic Discharge Approach Guidance Document
Page 12

30 page PDF

1.2MB

Implementation

Getting it right from the start - the implementation framework

In order to ensure that the DDD process becomes business as usual, it is necessary to consider all of the things that cause people to revert to 'safe' historical practices. The following table (page 23, 24) is a high level example of what needs to be considered during implementation.

IT PREP SET-UP GO LIVE SUSTAINABILITY
Ensure wardview, or the mechanism to view EDD is viewable/accessible Identify area to hold the morning meeting Identify a facilitator for the first few days, and a 'scribe' each day, coach and teach as necessary Ensure 'golden hour' ward rounds become the appropriate next step - sick patients, then discharges, then all other patients
Ensure everyone knows how to log on and sort in ' EDD order' Ensure the MDT know where and when the meeting will be Write a rota for the first two weeks to support via the ' CCC' role to enforce escalation Create escalation process with examples of delay and names/numbers to call (eradicate acceptance of delay)
Test the log in and 'change view' process Publicise where/when/why/how often you hold these meetings Benchmark ward data pre-start, number of discharges, pre-noon discharges, LOS, discharge lounge utilisation, delayed days, delayed patients etc Revisit the numbers - devise an improving trajectory of discharge numbers and pre-noon discharges - use as part of PDP/development sessions
Ensure ward-view (or other system) is up to date with EDDs for all patients Meet with management team ( GM, CSM, Lead Nurse), Consultants, Senior Charge Nurses, Ward Managers) to explain the process and agree the supporting structure Link the improved understanding of discharge numbers into the huddle/bed managers/discharge lounge Ensure the meetings happen at weekend, even if it's just the nurses who agree and prioritise discharge tasks, induct all new staff to this process on day 1
IT PREP SET-UP GO LIVE SUSTAINABILITY
Ensure wardview, or the mechanism to view EDD is viewable/accessible Identify area to hold the morning meeting Identify a facilitator for the first few days, and a 'scribe' each day, coach and teach as necessary Ensure 'golden hour' ward rounds become the appropriate next step - sick patients, then discharges, then all other patients
Ensure everyone knows how to log on and sort in ' EDD order' Ensure the MDT know where and when the meeting will be Write a rota for the first two weeks to support via the ' CCC' role to enforce escalation Create escalation process with examples of delay and names/numbers to call (eradicate acceptance of delay)
Test the log in and 'change view' process Publicise where/when/why/how often you hold these meetings Benchmark ward data pre-start, number of discharges, pre-noon discharges, LOS, discharge lounge utilisation, delayed days, delayed patients etc Revisit the numbers - devise an improving trajectory of discharge numbers and pre-noon discharges - use as part of PDP/development sessions
Ensure ward-view (or other system) is up to date with EDDs for all patients Meet with management team ( GM, CSM, Lead Nurse), Consultants, Senior Charge Nurses, Ward Managers) to explain the process and agree the supporting structure Link the improved understanding of discharge numbers into the huddle/bed managers/discharge lounge Ensure the meetings happen at weekend, even if it's just the nurses who agree and prioritise discharge tasks, induct all new staff to this process on day 1

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