NHS Dumfries and Galloway: balancing capacity with demand

Case study focusing on patient flow and Daily Dynamic Discharge at Dumfries and Galloway Royal Infirmary.


Impact

The hospital measured quantitative and qualitative impacts on Ward 10 four weeks after it introduced Daily Dynamic Discharge. This was fed back to the team so they could see the difference their hard work was making.

Further data was then generated after 12 weeks. This data compared the 12 weeks prior to implementation with the similar 12 weeks the previous year.

It revealed a more even distribution of discharges and admissions, with less of a peak on Fridays.

Figure 7: Ward 10 Discharges Pre and Post Change to Daily Dynamic Discharge ( DDD)

Figure 7: Ward 10 Discharges Pre and Post Change to Daily Dynamic Discharge

The average number of weekly discharges increased from 26.5 to 30.2, an increase of 3.7 discharges per week. Average length of stay dropped from 6.8 days to 6.2 days, a saving of 0.5 days.

Figure 8: Dumfries and Galloway Royal Infirmary ( DGRI) Ward 10 Hourly Discharge Profile Pre and Post Daily Dynamic Discharge ( DDD)

Figure 8: Dumfries and Galloway Royal Infirmary (DGRI)Ward 10 Hourly Discharge Profile Pre and Post Daily Dynamic Discharge

More discharges were taking place earlier in the day. The median discharge time was 32 minutes earlier once Daily Dynamic Discharge had been implemented. Previously, a third (33%) of patients were discharged before 4pm. After implementation, this rose to 44%.

The multidisciplinary team meeting took significantly less time after implementation - 45 minutes in total - and pharmacy reported that prescriptions were being written up in advance of discharge.

Staff said they felt more in control. The fact that patients were being discharged earlier in the day meant that patients could be admitted in a timely manner from the Acute Medical Unit. Patient flow was starting to improve.

Contact

Email: Jessica Milne, jessica.milne@gov.scot

Phone: 0300 244 4000 – Central Enquiry Unit

The Scottish Government
St Andrew's House
Regent Road
Edinburgh
EH1 3DG

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