Selecting the Exemplar Ward
Nurse Managers, Marian McDonald and Jackie Nicholson and Assistant General Manager, Carole Morton met to discuss which acute medical ward should be chosen as the exemplar ward for Daily Dynamic Discharge.
Project Manager, Patsy Pattie said:
"We chose Ward 10, a medical ward with a mix of specialties (including Rheumatology, Infectious Diseases, Gastroenterology and Haematology) because its complexity made it an ideal exemplar ward. The Senior Charge Nurse was very motivated and improvement-focused, having already introduced new ways of working to prepare for the move to the new hospital. We began implementing Daily Dynamic Discharge on this ward in September 2016."
(Left to right) Dr Neil Evans, GPST - Alison Banford, Physiotherapist - Dr Rashed Bubakar, SD in Haematology - Lorna Henderson, Staff Nurse - Lauren Wismach, Staff Nurse - Jackie Nicholson, Nurse Manager - Vicki Nicoll, SCN - Dr Manjul Medhi, Locum Specialty Doctor in Infectious Diseases - Dr Avi Chowdhury, FY1 - Dr Andrew McCallum, CT3 Medicine - Dr William Beresford, FY2
Key to Acronyms:
GPST - General Practice Specialty Trainee
SD - Specialty Doctor
SCN - Senior Charge Nurse
FY1 - Foundation Doctor Year 1
FY2 - Foundation Doctor Year 2
CT3 - Core Trainee Year 3
The hospital's Health Intelligence Analyst produced an activity profile for the ward focussing on the daily admissions and discharges across the week. In common with the rest of the hospital, the largest number of discharges from Ward 10 occurred on Fridays. The main reason for this was that the weekly ward multidisciplinary team meetings took place on Thursdays. Actions from these meetings were addressed which resulted in patients being ready for discharge on Fridays.
"The data has always been readily available via the dashboard, but seeing it in front of them in black and white really brought home to staff the urgent need for change." Bill Mitchell, Health Intelligence Analyst
Figure 4: Ward 10, Admission and Discharge Numbers By Day of Week
The data showed that demand outstripped capacity on four days per week, with the site relying on the additional Friday capacity to make it through the weekend.
Figure 5: Ward 10, Hourly Discharge Profile
The majority of Ward 10 discharges took place in the afternoon and early evening, with a peak of 71% between 3pm and 8pm.
Email: Jessica Milne, firstname.lastname@example.org
Phone: 0300 244 4000 – Central Enquiry Unit
The Scottish Government
St Andrew's House